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Relation between iron-overload indices, cardiac echo-Doppler, and biochemical markers in thalassemia intermedia

Hussain Isma'eel1, Abdul Hamid El Chafic, Fuad El Rassi

  • 1Department of Internal Medicine Hematology-Oncology Division, American University of Beirut, Medical Center, Beirut, Lebanon.

The American Journal of Cardiology
|July 22, 2008
PubMed

Insights

Cardiovascular issues are common in thalassemia intermedia. This study found liver iron concentration correlates with pulmonary artery pressure, and amino terminal pro-brain natriuretic peptide (NT-proBNP) relates to diastolic dysfunction, highlighting tissue Doppler imaging

Area of Science:

  • Cardiology
  • Hematology
  • Medical Imaging

Background:

  • Cardiovascular impairment significantly impacts morbidity and mortality in thalassemia intermedia patients.
  • Echocardiography is crucial for assessing cardiac function in this population.
  • Understanding the relationship between hematologic factors, iron load, and cardiac status is vital.

Purpose of the Study:

  • To evaluate left heart condition in thalassemia intermedia patients using echocardiography.
  • To investigate the correlation between echocardiographic findings and hematologic variables (NT-proBNP, ferritin, hemoglobin) and liver iron concentration (LIC).
  • To determine the utility of pulse-wave Doppler versus tissue Doppler imaging in assessing diastolic dysfunction.

Main Methods:

  • Echocardiographic assessment including pulse-wave Doppler and tissue Doppler imaging was performed on 74 thalassemia intermedia patients.
  • Blood samples were analyzed for amino terminal pro-brain natriuretic peptide (NT-proBNP) in a subgroup of 19 patients.
  • Correlation analyses were conducted between echocardiographic parameters, NT-proBNP, hemoglobin, ferritin, and liver iron concentration (LIC).

Main Results:

  • A significant correlation was observed between liver iron concentration (LIC) and pulmonary artery systolic pressure.
  • NT-proBNP showed a significant correlation with the ratio of left ventricular early rapid filling wave to early diastolic velocity at the mitral annulus (r = 0.50, p = 0.04) and hemoglobin (r = -0.49, p = 0.03).
  • Tissue Doppler imaging proved more effective than pulse-wave Doppler in characterizing left ventricular diastolic dysfunction.

Conclusions:

  • Liver iron loading is indicative of cardiovascular sequelae in thalassemia intermedia.
  • NT-proBNP levels are associated with left ventricular diastolic dysfunction and hemoglobin levels.
  • Tissue Doppler imaging is recommended for assessing left ventricular diastolic dysfunction in thalassemia intermedia patients, independent of left ventricular filling pressures.

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