Evaluation of electrocardiography, echocardiography and cardiac T2* for cardiac complications in beta thalassemia major

Int J Cardiovasc Imaging. 2022 Mar;38(3):533-542. doi: 10.1007/s10554-021-02421-x. Epub 2021 Oct 8.

Abstract

Cardiac complications such as heart failure and arrhythmias caused by "iron-induced" cardiomyopathy are considered as the primary cause of death in the patients with β-thalassemia major. The aim of this study was to evaluate electrocardiography, echocardiography according cardiac T2* and ferritin findings of patients followed-up for β-thalassemia major, and to investigate the importance of these findings for early detection of cardiac complications. The study included 41 patients and 25 healthy individuals with matched age and gender. The cardiac T2* results revealed a cardiac iron load below 20 ms in 12 (29.27%) patients, and above 20 ms in 29 (70.73%) patients. All electrocardiography parameters significantly increased in the patient group when compared to the control group (p < 0.05). All parameters except P wave segment in electrocardiography and T peak-end/QT ratio were significantly higher in the group with cardiac T2* < 20 ms than the group with cardiac T2* > 20 ms (p < 0.05). Intraventricular septum thickness, left ventricular posterior wall thickness, left ventricular mass and left ventricular mass index detected by echocardiography were significantly higher in the group with T2* < 20 ms (p < 0.05). Electrocardiography, echocardiography, cardiac T2* and ferritin findings should be carefully evaluated in these patients in order to detect early signs of cardiac complications.

Keywords: Cardiac T2*; Echocardiography; Electrocardiography; Ferritin; Thalassemia major.

MeSH terms

  • Echocardiography / methods
  • Electrocardiography
  • Humans
  • Iron Overload* / etiology
  • Magnetic Resonance Imaging / methods
  • Predictive Value of Tests
  • beta-Thalassemia* / complications
  • beta-Thalassemia* / diagnosis