Related Experiment Video
Updated: Jul 18, 2026
Murine Echocardiography of Left Atrium, Aorta, and Pulmonary Artery
Published on: February 20, 2017
The relation between left ventricular diastolic indices and serum ferritin in thalassemia major
Zahara Ashena1, Sorush Ghafurian, Mohammad Ali Ehsani
1Bahrami Children Hospital, Tehran University of Medical Sciences, Tehran, Iran. Zashena@gmail.com
Insights
Serum ferritin levels do not reliably indicate iron overload in thalassemia major patients. However, left ventricular diastolic function may be affected in older adolescents, suggesting a need for further research with larger sample sizes.
Area of Science:
- Cardiology
- Hematology
- Biochemistry
Background:
- Iron overload is a significant complication in thalassemia major patients due to regular blood transfusions.
- Iron-induced cardiomyopathy, particularly diastolic dysfunction, is a leading cause of mortality.
- Serum ferritin is an unreliable biomarker for assessing body iron stores in inflammatory conditions.
Purpose of the Study:
- To investigate the association between left ventricular diastolic indices and serum ferritin levels in thalassemia major patients with preserved systolic function.
- To explore the potential of diastolic indices as early indicators of iron storage.
- To identify potential age-related differences in iron's impact on cardiac function.
Main Methods:
- Cross-sectional study involving 29 thalassemia major patients with normal left ventricular systolic function.
- Measurement of serum ferritin concentration and various left ventricular diastolic indices.
- Linear regression analysis to assess correlations between cardiac and hematological parameters.
Main Results:
- No significant correlation was observed between serum ferritin concentration and left ventricular diastolic indices overall.
- A trend towards altered diastolic function (increased E and A wave peaks) was noted in patients above 15 years of age (p ≈ 0.05).
- Younger patients (<15 years) did not show significant changes in diastolic indices related to serum ferritin.
Conclusions:
- Serum ferritin alone is not a sufficient indicator of cardiac iron burden in thalassemia major.
- Age appears to be a modifying factor, with older adolescents potentially exhibiting early signs of diastolic dysfunction.
- Further longitudinal studies with larger cohorts and historical ferritin data are warranted to clarify the relationship between iron storage and diastolic function.
Abstract:
Iron-induced heart failure is the primary cause of death in thalassemia major patients who receive continuous transfusions. Recent studies have suggested that diastolic function is impaired prior to systolic function in process of hemochromatosis, but they did not come to agreement on the first impaired diastolic index. Additionally, serum ferritin concentration is not a reliable indicator of body iron storage since it increases in any simple inflammation. Accordingly, the authors undertook this study to assess any association between left ventricular diastolic indices and serum ferritin in thalassemic patients with normal systolic function to estimate the true amount of body iron storage and correct it in earlier stages. Serum ferritin concentration and diastolic indices were measured in 29 patients with normal left ventricular systolic function. Linear regression test was used to find any association between hematological and cardiac factors. No significant association was found between diastolic indices and serum ferritin concentration. But the results were quite different in patients above and below 15 years of age; standardized coefficients (r) for peak of E and A were increased in patients above 15, and the significance was close to .05, unlike those of younger group. Although no correlation was found between serum ferritin and diastolic indices, the results were noteworthy in patients above 15. To appropriately judge this relation, the study must be continued with a bigger sample size and having patients' mean serum ferritin concentration during the 2 past years.
Related Concept Videos
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
01:29Cardiomyopathy IV: Restrictive Cardiomyopathy