Vol 54, No 6 (2023)
Original research article
Published online: 2023-11-22

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Plenary survey on incidence of cardiac complications among transfusion-dependent thalassemia patients

Haleh Bozorgi1, Shahdad Khosropanah2, Sezaneh Haghpanah1, Omid Reza Zekavat1
Acta Haematol Pol 2023;54(6):399-405.


Introduction: Cardiac complications are the leading cause of mortality amongst transfusion-dependent thalassemia (TDT) patients. The multifactorial etiology of cardiac disorders has made their management quite challenging. Therefore, in addition to evaluating the incidence of heart failure (HF) and pulmonary hypertension (PHT), the associated factors were assessed amongst 737 TDT patients, aiming to achieve a plenary perspective of their cardiac disorders and relative factors. Material and methods: In this cross-sectional, we evaluated the incidence of HF and PHT amongst 737 TDT patients while considering imperative factors such as endocrinopathies, iron status, and serum vitamin D level. Results: Incidence of total heart failure and pulmonary hypertension were estimated at 12.3% amongst participants, however, the rate of cardiac iron overload was about 40%. Splenectomy, serum vitamin D, low bone mass, age, gender, hypoparathyroidism, hypogonadism, and diabetes were significantly impairing the cardiac function of our patients. The latter results were concluded by univariate analysis and only the frequency of blood transfusion proved to have a risk effect on left ventricle ejection fraction. Conclusions: Cardiac iron overload has the highest impact on the incidence of cardiac disorders amongst TDT patients. Even though the significant statistical association between studied disorders and iron chelation regimen, endocrinopathies, splenectomy, serum vitamin D, and total body iron status were not observed, however about clinical practice, their effect could not be ignored and require further studies to achieve efficient management of thalassemia patients with cardiac disorders.

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