Analysis of various electrocardiographic and echocardiographic parameters in beta thalassemia patients with iron...

Cardiac magnetic resonance imaging (MRI) T2* is the gold standard investigation for predicting cardiac iron overload. Being costly and resource-limited, other investigations that are cost-effective and easily available are needed.

We studied various electrocardiographic and echocardiographic parameters of transfusion-dependent thalassemia patients between 2022 and 2024 in our tertiary pediatric cardiac center in southern India.

Among our 50 patients of the age group 8 years-30 years (mean age group: 19.9 years ± 5.57), 62% of patients were males. Ninety-eight percent of our patients were asymptomatic, though 32% had MRI evidence of severe iron overload. Twenty-two percent of them had ferritin of more than 5000 µg/dL. There was a significant difference in P wave dispersion, mitral valve E/A, and E/e' seen among patients with normal and abnormal cardiac MRI.

Regular follow-up with tracking of the electrocardiographic and echocardiographic parameters can be used as an effective screening to guide timing for cardiac MRI and titrate chelation therapy. Early identification of iron overload, prompt initiation of chelation therapy, and ensuring adequate compliance with medical treatment, along with titration of chelation based on serial assessments, play a major role in improving the quality of life and lifespan for these patients.