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Early detection of cardiac involvement in beta-thalassemia children
Kritvikrom Durongpisitkul1, Siwiluck Kruasukon, Charuwan Kangkagate
1Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Insights
Cardiac involvement affects asymptomatic beta-thalassemia patients. Chest X-rays and ECGs are recommended for screening to detect cardiac issues in children with beta-thalassemia major and beta-thalassemia/HbE.
Area of Science:
- Hematology
- Cardiology
- Pediatrics
Background:
- Beta-thalassemia major and beta-thalassemia/HbE are significant causes of chronic hemolytic anemia in Thailand.
- Cardiac complications are a major concern in beta-thalassemia patients.
Purpose of the Study:
- To identify variables associated with cardiac involvement in asymptomatic beta-thalassemia patients.
- To evaluate screening methods for cardiac involvement in this population.
Main Methods:
- A study of 211 asymptomatic beta-thalassemia major and beta-thalassemia/HbE patients aged 2.6-18.2 years.
- Inclusion of clinical history, physical examination, chest X-ray, electrocardiogram (ECG), and echocardiogram.
- Cardiac involvement defined by abnormal echocardiogram findings.
Main Results:
- Cardiac involvement was detected in 12.3% of patients.
- Abnormal chest X-ray (cardiothoracic ratio > 0.55) and ECG findings (ventricular hypertrophy) were associated with cardiac involvement.
- Older age and lower pretransfusion hematocrit were also linked to cardiac involvement.
Conclusions:
- Chest X-ray and ECG are valuable screening tools for detecting cardiac involvement in asymptomatic children with beta-thalassemia.
- Early screening can aid in managing potential cardiac complications in beta-thalassemia patients.
Background:
Beta-thalassemia major and beta-thalassemia/HbE are the important causes of chronic hemolytic anemia in Thailand. The objectives of the study were to determine variables associated with cardiac involvement in asymptomatic beta-thalassemia patients.
Patients And Method:
The authors studied beta-thalassemia major and beta-thalassemia/HbE patients who came to the clinic between July 1st 1999 and July 31st 2000. There were 211 asymptomatic patients included in study. Their ages ranged from 2.6 to 18.2 years. Previous clinical history including blood transfusion and iron chelation were recorded. All patients received a thorough physical examination, chest X-ray, electrocardiogram and echocardiogram. Patients who had abnormal systolic or diastolic function detected by echocardiogram were identified as having cardiac involvement.
Results:
Cardiac involvement was found in 26 patients (12.3%). There was no difference in physical examination between patients who had and did not have cardiac involvement. Abnormal chest X-Ray defined as cardiothoracic (CT) ratio>0.55 and electrocardiogram (ECG) findings of left or right ventricular hypertrophy were associated with cardiac involvement. Other associated findings were older age and lower average pretransfusion hematocrit (23 +/- 6.6%).
Conclusions:
In asymptomatic beta-thalassemia children, chest X-ray and ECG should be used for screening patients for the detection of cardiac involvement.