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Parameters of tissue iron overload and cardiac function in patients with thalassemia major and intermedia
Affiliations- Tehran Islamic Azad University of Medical Sciences, Array, Tehran
- Hematology Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz
- Bushehr University of Medical Sciences, Array, Bushehr
- Neonatology and Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz
- Thalassemia Ward, Shahid Dastgheib Hospital, Shiraz University of Medical Sciences, Shiraz
- Student of Medicine, Shiraz University of Medical Sciences, Shiraz
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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.
Keywords
red blood cell; iron overload; β-thalassemia; echocardiography; B-type natriuretic peptide
About this articleTitle
Parameters of tissue iron overload and cardiac function in patients with thalassemia major and intermedia
Journal
Issue
Pages
95-101
Published online
2020-06-01
Page views
189
Article views/downloads
194
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