EFFECT OF IRON CHELATION THERAPY ON SYSTOLIC
CARDIAC FUNCTION IN PATIENTS WITH THALASSAEMIA MAJOR
Samir A.Abdelaziz,
FRCPCH(London); RAK, UAE
Abeer I. Khalafawi, MRCP(UK); RAK, UAE
Material and methods: Congestive heart failure is the most
common complication ofbeta-thalassemia major. We conducted a study on 14
patients aged 5 to 18 years, who were given irregular blood transfusions
and very occasional chelation therapy. Their serum ferritin level ranged
between 1954 to 11654 mcg/L. They undergone dobutamine excercise
echocardiographic study to assess left ventricular systolic functions. They
went on regular blood transfusions regimen so as to keep average Hb at 12.5
gmldl, together with strict chelation policy, for two years. All of them
but one, were compliant and their serum ferritin decreased to 973-4872 m
cg/L.Cardiac functions were repeated in the same way.
Results: There was no radiological or
clinical evidence of heart failure in any of these patients before and
after treatment. Echocardiographic study showed non significant statistical
difference in ejection fraction and borderline significant difference in
fractional shortening (t-test). There was also no correlation between
ejection fraction, serum ferritin, age and amount of blood transfusion.
Conclusion: Iron overload does not
appear to be the main cause of congestive heart failure in patients with B
Thalassemia major & this cofirms different other studies.