The Association between Serum Ferritin Level, Tissue Doppler Echocardiography, Cardiac T2* MRI, and Heart Rate Recovery in Patients with Beta Thalassemia Major

Isa Oner Yuksel ； Erkan Koklu ； Erdal Kurtoglu ； Sakir Arslan ； Goksel Cagirci ； Volkan Karakus ； Gorkem Kus ； Serkan Cay ； Selcuk Kucukseymen

《Acta Cardiologica Sinica》 32卷2期 (2016/03) Pp. 231-238

https://doi.org/10.6515/ACS20150824A

並列摘要

Background: It is generally well-understood that iron-mediated cardiomyopathy is the major complication that can arise from beta thalassemia major (TM). Therefore, early diagnosis, risk stratification, and the effective treatment of beta TM patients are clinically important to optimize long-term positive outcomes. Methods: This study included 57 beta TM patients with a mean age of 25± 7 years. We determined the serum ferritin level, echocardiography, heart rate recovery (HRR), and cardiac magnetic resonance (CMR) T2* in all patients. CMR T2* findings were categorized as normal myocardium (T2* ＞ 20 ms), and myocardial involvement (T2* ≤ 20 ms). HRR values at 1-5 min (HRR1-5)were recorded; Subsequently. HRRwas calculated by subtracting the heart rate at each time point from the heart rate at peak exercise. Results: There was a significant negative correlation between the serum ferritin level and the cardiac T2* MRI findings (r = -0.34, p = 0.009). A similar result was found in the negative correlation between serum ferritin and all heart rate recovery values. There was a significant positive correlation between HRR1, HRR2, and HRR3 values, and CMR T2* (T2* heart rate recovery (HRR)1: r = 0.51, p ＜ 0.001; T2* HRR2: r = 0.48, p ＜ 0.001; T2* HRR3: r = 0.47, p ＜ 0.001, respectively). Conclusions: The serum ferritin level and echocardiography can be used to predict the presence of myocardial iron load in beta TM patients. Therefore, HRR can be used to screen beta TM patients, and the clinical use of HRR can be a predictive marker for autonomic dysfunction in beta TM patients.

並列關鍵字

Beta thalassemia major ； Cardiac magnetic resonance T2* ； Heart rate recovery ； Iron overload ； Serum ferritin level ； Tissue Doppler imaging