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


BACKGROUND
Beta thalassemia major • Cardiac magnetic resonance T2* • Heart rate recovery • Iron overload • Serum ferritin level • Tissue Doppler imaging.
Department of Cardiology;
Isa Oner
IO
Yuksel
Department of Cardiology;
Erkan
E
Koklu
Department of Haematology, Antalya Education and Research Hospital;
Erdal
E
Kurtoglu
Department of Cardiology;
Sakir
S
Arslan
Department of Cardiology;
Goksel
G
Cagirci
Department of Haematology, Antalya Education and Research Hospital;
Volkan
V
Karakus
Department of Cardiology;
Gorkem
G
Kus
Department of Cardiology, Türkiye Yüksek İhtisas Education and Research Hospital, Ankara, Turkey.
Serkan
S
Cay
Department of Cardiology;
Selcuk
S
Kucukseymen