open access

Vol 51, No 2 (2020)
ORIGINAL RESEARCH ARTICLE
Submitted: 2019-11-04
Published online: 2020-06-01
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Parameters of tissue iron overload and cardiac function in patients with thalassemia major and intermedia

Sarah Safniyat1, Nader Shakibazad23, Sezaneh Haghpanah2, Hamid Amoozegar4, Mehran Karimi2, Sanaz Safaei5, Saeed Safniyat6, Hamid Mohammadi4, Omid Reza Zekavat2
DOI: 10.2478/ahp-2020-0018
·
Acta Haematol Pol 2020;51(2):95-101.
Affiliations
  1. Tehran Islamic Azad University of Medical Sciences, Array, Tehran
  2. Hematology Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz
  3. Bushehr University of Medical Sciences, Array, Bushehr
  4. Neonatology and Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz
  5. Thalassemia Ward, Shahid Dastgheib Hospital, Shiraz University of Medical Sciences, Shiraz
  6. Student of Medicine, Shiraz University of Medical Sciences, Shiraz

open access

Vol 51, No 2 (2020)
ORIGINAL RESEARCH ARTICLE
Submitted: 2019-11-04
Published online: 2020-06-01

Abstract

Background

Noninvasive T2* magnetic resonance imaging (MRI) assessment can stratify the risk of subsequent cardiac dysfunction in β-thalassemia major (TM) and β-thalassemia intermedia (TI) patients. The normal level of N-terminal pro B-type natriuretic peptides (NT-proBNP) can rule out acute heart failure.

Aim

We aim to investigate the relation of NT-proBNP level, T2* MRI, and echocardiographic findings in TM and TI patients.

Materials and methods

In this cross-sectional study, 41 TM patients, 41 TI patients, and 41 healthy individuals (HI) were enrolled. NT-proBNP level, T2* MRI, and two-dimensional echocardiography were assessed for all patients and controls.

Results

There was statistically significant correlation between NT-proBNP levels and mitral inflow late diastolic velocity ( = −0.538; = 0.006) in TM group. There was statistically significant correlation between NT-proBNP levels and tricuspid annulus systolic velocity ( = −0.438; = 0.028), systolic velocity of septum ( = −0.472; = 0.020), and mitral inflow early-to-late diastolic wave ratio ( = 0.592; = 0.002) in TM group.

Conclusion

Early diagnosis and treatment of myocardial iron overload are likely to prevent the mortality in patients with established ventricular dysfunction. Since NT-proBNP levels were not significantly increased in documented left ventricular (LV) diastolic dysfunction, this factor may not be sensitive for the detection of latent LV diastolic dysfunction in the early stages of disease progression.

Abstract

Background

Noninvasive T2* magnetic resonance imaging (MRI) assessment can stratify the risk of subsequent cardiac dysfunction in β-thalassemia major (TM) and β-thalassemia intermedia (TI) patients. The normal level of N-terminal pro B-type natriuretic peptides (NT-proBNP) can rule out acute heart failure.

Aim

We aim to investigate the relation of NT-proBNP level, T2* MRI, and echocardiographic findings in TM and TI patients.

Materials and methods

In this cross-sectional study, 41 TM patients, 41 TI patients, and 41 healthy individuals (HI) were enrolled. NT-proBNP level, T2* MRI, and two-dimensional echocardiography were assessed for all patients and controls.

Results

There was statistically significant correlation between NT-proBNP levels and mitral inflow late diastolic velocity ( = −0.538; = 0.006) in TM group. There was statistically significant correlation between NT-proBNP levels and tricuspid annulus systolic velocity ( = −0.438; = 0.028), systolic velocity of septum ( = −0.472; = 0.020), and mitral inflow early-to-late diastolic wave ratio ( = 0.592; = 0.002) in TM group.

Conclusion

Early diagnosis and treatment of myocardial iron overload are likely to prevent the mortality in patients with established ventricular dysfunction. Since NT-proBNP levels were not significantly increased in documented left ventricular (LV) diastolic dysfunction, this factor may not be sensitive for the detection of latent LV diastolic dysfunction in the early stages of disease progression.

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Keywords

red blood cell; iron overload; β-thalassemia; echocardiography; B-type natriuretic peptide

About this article
Title

Parameters of tissue iron overload and cardiac function in patients with thalassemia major and intermedia

Journal

Acta Haematologica Polonica

Issue

Vol 51, No 2 (2020)

Pages

95-101

Published online

2020-06-01

Page views

131

Article views/downloads

143

DOI

10.2478/ahp-2020-0018

Bibliographic record

Acta Haematol Pol 2020;51(2):95-101.

Keywords

red blood cell
iron overload
β-thalassemia
echocardiography
B-type natriuretic peptide

Authors

Sarah Safniyat
Nader Shakibazad
Sezaneh Haghpanah
Hamid Amoozegar
Mehran Karimi
Sanaz Safaei
Saeed Safniyat
Hamid Mohammadi
Omid Reza Zekavat

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