A survey on structural and functional cardiac abnormalities in transfusion dependent thalassemia, a report from the south-east of Iran

Background:

Cardiac abnormalities are common complications in Transfusion Dependent Thalassemia (TDT).

Objectives:

This study aimed to assess functional and structural cardiac abnormalities in TDT patients in Zabol, Sistan and Baluchistan province in south-east of Iran.

Patients and Methods:

This cross-sectional study was conducted on 85 TDT patients selected via simple random sampling. Demographic information was obtained using a questionnaire. Additionally, clinical and laboratory data were extracted from medical records. Cardiac assessment was conducted by standard Doppler echocardiography. After all, the data was statistically analyzed using the SPSS statistical software, version 19.

Results:

In this study, 54 participants (63.5%) were female and 31 ones (36.5%) were male. The participants’ mean age was 19.2 ± 6.1 years. In addition, 58 patients (68.2%) had at least one cardiac abnormality. The mean of Left Ventricular Ejection Fraction (LVEF) was 60.3 ± 8.5% (range: 40 - 80%). The most common cardiac conditions were Tricuspid Regurgitation (TR) (58.8%), Left Ventricular Diastolic Dysfunction (LVDD) (43.5%), Pulmonary valve Insufficiency (PI) (35.3%), and Mitral Regurgitation (MR) (32.9%). Moreover, Left Ventricular Systolic Dysfunction (LVSD), Aortic Insufficiency (AI), and pericard effusion were detected in 6 (7.1%), 2 (2.4%), and 2 patients (2.4%), respectively. The results revealed a significant association between LVDD and splenomegaly, splenectomy, hepatomegaly, chelation therapy, and anti-HCV positivity. Indeed, anti-HCV positivity was significantly associated with MR and lower LVEF. Patients with positive anti-HCV results presented a higher risk of cardiac dysfunction (OR = 4.1, 95% CI: 0.8 - 19.8, P = 0.022) and LVEF < 55% (OR = 4.2, 95% CI: 1.2 - 14.9, P = 0.027).

Conclusions:

The results indicated anti-HCV positivity as a significant risk factor for heart dysfunction in TDT patients. Thus, cardiac functionality is recommended to be assessed regularly in TDT patients.