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Published on: October 28, 2020
Vitamin D levels and left ventricular function in beta-thalassemia major with iron overload
Mrudula Pala1, Kamalakshi G Bhat2, Sharath Manya1
1Department of Pediatrics, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India.
Insights
Vitamin D deficiency in beta-thalassemia major patients with iron overload is linked to reduced cardiac function. Supplementation may prevent heart complications in these children.
Area of Science:
- Cardiology
- Hematology
- Endocrinology
Background:
- Beta-thalassemia major patients on regular transfusions face high risks of heart disease due to chronic iron overload.
- Cardiac complications are a leading cause of mortality in this patient population.
Purpose of the Study:
- To investigate the relationship between vitamin D levels and left ventricular function in children with beta-thalassemia major and iron overload.
- To understand how iron overload and vitamin D status impact cardiac health in these patients.
Main Methods:
- A cross-sectional study involving children with beta-thalassemia major.
- Measurement of serum vitamin D and ferritin levels.
- Assessment of left ventricular function using ejection fraction (EF) and fractional shortening (FS) via 2D echocardiography.
Main Results:
- A significant negative correlation was observed between vitamin D and serum ferritin levels (r = -0.447, p < 0.001).
- Vitamin D levels showed a significant positive association with ejection fraction (p=0.034) and fractional shortening (p=0.014).
- Higher ferritin levels correlated with lower vitamin D, impacting cardiac function.
Conclusions:
- Increasing ferritin levels are associated with decreased vitamin D, negatively affecting cardiac function (fractional shortening) in beta-thalassemia major patients.
- Vitamin D deficiency exacerbates cardiac complications in iron-overloaded patients, suggesting vitamin D supplementation as a preventive strategy.
Abstract:
Heart disease is the primary cause of death in patients with beta-thalassemia major. The study aimed to determine the association between vitamin D and left ventricular function in patients with beta-thalassemia major with iron overload. A cross-sectional hospital-based study was conducted, where the vitamin D and ferritin levels of children living with beta-thalassemia major were measured, and left ventricular function was assessed utilizing ejection fraction (EF) and fractional shortening (FS) using 2D echocardiography. The mean serum ferritin was 4622 ± 2289 ng/ml, and the mean serum vitamin D levels were 22 ± 7.7 ng/ml. The mean values of EF were 62.30 ± 6.9%, and FS was 31.21 ± 4.8%. Statistically significant negative correlation (r = -0.447, p < 0.001) was found between vitamin D and serum ferritin values, and a significant positive association was found between vitamin D levels concerning EF and FS with a p-value of 0.034 and 0.014, respectively.Conclusion: It was observed that increasing ferritin was associated with lower vitamin D levels which in turn influenced fractional shortening /cardiac function in these patients. What is Known: • Patients with Beta Thalassemia major on long term transfusion are prone to develop heart disease / cardiac failure due to chronic iron overload. What is New: • Patients with beta thalassemia major on long term term transfusions with iron overload who are vitamin D deficient are more prone to the cardiac complications which inturn can be prevented by vitamin D supplementation.
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