title: Comparison of Doppler echocardiographic and tissue Doppler velocity data in beta-thalassaemia major with high and normal NT-proBNP levels of children in the south-east region of Turkey.
abstract: BACKGROUND
  It has been reported that N-terminal pro-brain natriuretic peptide (NT-proBNP) is early biomarker of iron- induced cardiomyopathy in β-thalassemia major (β-TM). In this study, we aimed to assess the Doppler echocardiographic, tissue Doppler velocity datas and clinical characteristics in β-TM patients with high and normal NT-proBNP levels who have normal systolic function.
  
  
  METHODS
  Fifty-eight β-TM patients who were on regular transfusion in every 3-4 weeks for more than one year and 20 healthy children were included into the study. According to NT-proBNP levels, β-TM patients are divided in two groups. Group I: the patients with high NT-proBNP levels; Group II: the patients with normal NT-proBNP levels.
  
  
  RESULTS
  The mean serum NT-proBNP levels were significantly increased in patients with β-TM compared to control group (P<0.05). The serum ferritin levels were ranged between 676-9,476 ng/mL (mean: 3,716±2,003 ng/mL) in β-TM. No correlation was found between ferritin and NT-pro BNP in patients with β-TM. The mean age and body surface area (BSA) were significantly low in group with high NT-proBNP compared to group with normal NT-proBNP (P<0.01). The mean heart rate, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were elevated, but not significantly in group with high NT-proBNP. Also, the mean ferritin and hemoglobin levels were decreased in this group compared to group with normal NT-proBNP, but statistically not significant. The left ventricular end diastole (LVED) diameters and left ventricular mass index (LVMI) values were found significantly decreased in group with high NT-proBNP compared to other group respectively (P<0.001, P<0,05). Right ventricular early diastolic tricuspid inflow velocity/early diastolic tissue Doppler indices (TDI) tricuspid annular velocity (RV E/E') were found increased in group with high NT-proBNP levels and difference was statistically significant (P<0.05). In addition, NT-pro BNP was found correlated with RV E/E' (r: 0.320).
  
  
  CONCLUSIONS
  According to our result, elevated NT-proBNP level was correlated with RVE/E', but it was not associated with ferritin level. The serum NT-proBNP level may be increased as a response to increased myocardial workload and decreased hemoglobin level in patients who have an increased need for transfusion.
authors.affiliation: 1 Health of Ministry, Şanlıurfa Children's Hospital Pediatric Hematooncology Clinic, Şanlıurfa, Turkey ; 2 Health of Ministry, Şanlıurfa Children's Hospital Pediatric Cardiology Clinic, Şanlıurfa, Turkey ; 3 Harran University, Pediatric Hematology Department, Şanlıurfa, Turkey ; 4 Ankalab laboratory, Ankara, Turkey.
authors.forename: Derya
authors.initials: D
authors.lastname: Özyörük
authors.affiliation: 1 Health of Ministry, Şanlıurfa Children's Hospital Pediatric Hematooncology Clinic, Şanlıurfa, Turkey ; 2 Health of Ministry, Şanlıurfa Children's Hospital Pediatric Cardiology Clinic, Şanlıurfa, Turkey ; 3 Harran University, Pediatric Hematology Department, Şanlıurfa, Turkey ; 4 Ankalab laboratory, Ankara, Turkey.
authors.forename: Taliha
authors.initials: T
authors.lastname: Öner
authors.affiliation: 1 Health of Ministry, Şanlıurfa Children's Hospital Pediatric Hematooncology Clinic, Şanlıurfa, Turkey ; 2 Health of Ministry, Şanlıurfa Children's Hospital Pediatric Cardiology Clinic, Şanlıurfa, Turkey ; 3 Harran University, Pediatric Hematology Department, Şanlıurfa, Turkey ; 4 Ankalab laboratory, Ankara, Turkey.
authors.forename: Yeşim
authors.initials: Y
authors.lastname: Oymak
authors.affiliation: 1 Health of Ministry, Şanlıurfa Children's Hospital Pediatric Hematooncology Clinic, Şanlıurfa, Turkey ; 2 Health of Ministry, Şanlıurfa Children's Hospital Pediatric Cardiology Clinic, Şanlıurfa, Turkey ; 3 Harran University, Pediatric Hematology Department, Şanlıurfa, Turkey ; 4 Ankalab laboratory, Ankara, Turkey.
authors.forename: Hüseyin Tuğrul
authors.initials: HT
authors.lastname: Çelik
keywords: N-terminal pro-brain natriuretic; Thalassemia major (TM); hemoglobin; peptide (NT-proBNP)
references.citation: Eur J Haematol. 2007 Jan;78(1):58-65
references.pmid: 17038018
references.citation: Eur J Heart Fail. 2007 May;9(5):531-6
references.pmid: 17317307
references.citation: Blood Cells Mol Dis. 2013 Jan;50(1):20-4
references.pmid: 23017692
references.citation: J Clin Pathol. 1974 Aug;27(8):652-5
references.pmid: 4421996
references.citation: Am J Med. 2001 Oct 1;111(5):349-54
references.pmid: 11583636
references.citation: Eur J Heart Fail. 2007 May;9(5):537-41
references.pmid: 17300987
references.citation: Med Trop (Mars). 2007 Dec;67(6):617-9
references.pmid: 18300526
references.citation: Circ Heart Fail. 2010 May;3(3):451-8
references.pmid: 20484195
references.citation: Circulation. 1990 Jul;82(1):88-94
references.pmid: 2364528
references.citation: Echocardiography. 2012 Mar;29(3):318-25
references.pmid: 22066516
references.citation: World J Cardiol. 2013 Aug 26;5(8):270-9
references.pmid: 24009816
references.citation: Eur Heart J. 2003 Jan;24(1):113-9
references.pmid: 12559943
references.citation: Can J Cardiol. 2009 Apr;25(4):213-8
references.pmid: 19340344
references.citation: Ann Hematol. 2007 Jun;86(6):429-34
references.pmid: 17262191
references.citation: Hematology Am Soc Hematol Educ Program. 2004;:14-34
references.pmid: 15561674
references.citation: Am J Med. 1978 Apr;64(4):547-55
references.pmid: 645720
references.citation: Congest Heart Fail. 2001 Nov-Dec;7(6):312-314
references.pmid: 11828176
references.citation: Circulation. 1964 Nov;30:698-705
references.pmid: 14226168
references.citation: Eur Heart J. 2001 Dec;22(23):2171-9
references.pmid: 11913479
references.citation: Hellenic J Cardiol. 2008 Nov-Dec;49(6):451-2
references.pmid: 19110935
references.citation: Ann N Y Acad Sci. 2005;1054:386-95
references.pmid: 16339687
references.citation: Circulation. 2009 Nov 17;120(20):1961-8
references.pmid: 19801505