Brain natriuretic peptide as a sensitive biomarker for early detection of cardiac affection in adult Egyptian patients with β-thalassemia

Abstract

Background Cardiac affection by iron overload is the leading cause of mortality and morbidity in patients with β-thalassemia owing to frequent blood transfusion, increased iron absorption, and hemolysis. N-terminal pro-B-type natriuretic peptide is a tool for early detection of cardiac hemosiderosis, as echo findings occur later. Methods We measured N-terminal pro-B-type natriuretic peptide in 45 β-thalassemia transfusion-dependent patients aged from 16 to 45 years and 30 controls of matched age and sex from Clinical Hematology Department, Ain Shams University hospital, which was correlated with both echo findings and serum ferritin level. Patients with congenital, ischemic heart disease and decompensated heart failure were excluded Results Brain natriuretic peptides (BNP) levels were higher in patients with β-thalassemia than the control group, with statistical significance. BNP levels were higher in patients with β-thalassemia major than in those with β-thalassemia minor. BNP level was higher in patients who received more frequent blood transfusion. When we correlated BNP level with the echo findings, statistically significant difference was found in patients with high right ventricular systolic pressure (RVSP) ˃ 35 mmHg but not with diastolic dysfunction; also a positive correlation was found between BNP level and ferritin but not the ejection fraction. Conclusion BNP levels were higher in patients with beta-thalassemia compared to control group and was correlated with the frequency of blood transfusion. BNP levels were correlated with increased RVSP ˃ 35 mmHg but not with early diastolic dysfunction, also BNP levels were correlated with ferritin level but not the ejection fraction.