Prevalence of Heart Failure in the Cases of Beta-thalassemia Major; Two Years Follow-Up

Abstract

<br/><em><span style="font-size: xx-small;">Inroduction: </span></em><br/><span style="font-family: CapitoliumNews,CapitoliumNews; font-size: xx-small;">Heart failure (HF) is an important cause of morbidity and mortality in the cases of Beta-thalassemia major. The purpose of this study was to estimate HF prevalence in these patients and to assess the survivability of those who were treated with intensive chelating therapy. </span><br/> <br/>Design and methods: <br/><span style="font-family: CapitoliumNews,CapitoliumNews; font-size: xx-small;"><span style="font-family: CapitoliumNews,CapitoliumNews; font-size: xx-small;">This cross sectional study included 72 beta-thalassemia major cases, the mean age at the time of referral was 15.7±6.2 years (range 6-35 years) and were followed in a prospective 2 year study. A self-reporting symptom questionnaire was administered, a 12-lead ECG was taken and an echocardiography was obtained from all participants. Echocardiography was performed at 6 month intervals or when a new symptom developed. </span></span><br/>Results: <br/><span style="font-family: CapitoliumNews,CapitoliumNews; font-size: xx-small;"><span style="font-family: CapitoliumNews,CapitoliumNews; font-size: xx-small;">Risk factors (except for iron overload) in the study population were hypothyroidism and diabetes mellitus. The male to female ratio was0.75.Twelve patients had left ventricular (LV) systolic dysfunction and 57,79% had LV diastolic dysfunction whereas 11,15% had RV failure. Fifty-nine (81%) patients had cardiac disease of which diastolic dysfunction was the most common manifestation .Those with systolic dysfunction were older at presentation (22 ± 6 years versus 31 ± 4 years; </span></span><em><span style="font-family: CapitoliumNews,CapitoliumNews; font-size: xx-small;"><em><span style="font-family: CapitoliumNews,CapitoliumNews; font-size: xx-small;">P </span></em></span></em><span style="font-family: CapitoliumNews,CapitoliumNews; font-size: xx-small;"><span style="font-family: CapitoliumNews,CapitoliumNews; font-size: xx-small;"><0.001), and had the highest mean serum ferritin level (3,355 ± 1241 ng/mL versus 6,397 ± 1,613 ng/mL; </span></span><em><span style="font-family: CapitoliumNews,CapitoliumNews; font-size: xx-small;"><em><span style="font-family: CapitoliumNews,CapitoliumNews; font-size: xx-small;">P </span></em></span></em><span style="font-family: CapitoliumNews,CapitoliumNews; font-size: xx-small;"><span style="font-family: CapitoliumNews,CapitoliumNews; font-size: xx-small;"><0.001). The 2 year survival rate in patients with beta thalassemia in this study was 98%. </span></span><br/>Conclusions: <br/><span style="font-family: CapitoliumNews,CapitoliumNews; font-size: xx-small;"><span style="font-family: CapitoliumNews,CapitoliumNews; font-size: xx-small;">Diastolic dysfunction is highly prevalent in even asymptomatic beta-thalassemia major patients. The high prevalence of diastolic dysfunction is indicative of a significant amount of the population who are at a high risk for HF </span></span>