The effect of iron overload in the hearts of patients with beta‐thalassemia

Background and hypothesis: An important complication of beta‐thalassemia is iron deposition in cardiac tissues resulting in fibrosis and dysfunction. Our aim was the investigation of the possible clinical effect of iron loading in the heart of patients with beta‐thalassemia prior to the appearance of symptoms of depressed systolic function. Methods: Thirty‐five patients with beta‐thalassemia, of whom 24 had the major type (Group 1) and 11 had the intermedia type (Group 2) were studied. Eleven age‐ and gender‐matched controls were also studied (Group 3). All patients were evaluated echocardiographically and were shown to have normal left ventricular systolic function and dimensions. Serum ferritin, atrial natriuretic peptide (ANP), left atrial diameter (LAD), peak early mitral inflow velocity (E), peak late mitral inflow velocity (A), E/A ratio, deceleration time of the mitral inflow E wave (DT), and isovolumic relaxation time (IVRT) were measured. Results: Univariate analysis showed that both groups of patients had similarly increased LAD and ANP plasma levels. Group 1 had a higher E/A ratio (2.27 ± 0.88) SS than Group 2 (1.69 ± 0.47, p = 0.05) and Group 3(1.50 ± 0.38, p = 0.01). Serum ferritin was significantly higher in Group 1 (3.526 ± 0.352) than in Group 2 (2.808 ± 0.288, p < 10–5) and Group 3 (2.139 ± 0.124, p