Correlation Between Serum Ferritin Levels and Echocardiographic Changes in Children with Beta-thalassaemia MajorA Cross-sectional Analytical Study

Abstract

Introduction: Heart failure secondary to iron overload is the leading cause of mortality in patients with beta-thalassaemia major. Prevention of myocardial siderosis is a key step to reducing the rate of mortality in thalassaemia children. Aim: To study the correlation between serum ferritin levels and echocardiography parameters in children with beta-thalassaemia major. Materials and Methods: This cross-sectional analytical study was conducted in the Department of Paediatrics, RG Kar Medical College and Hospital, Kolkata, India from March, 2020 to July, 2021. A total of 85 beta-thalassaemia major children aged between 2-12 years without having any active infections or congenital heart diseases, were included in this study. Blood samples were obtained from these children for serum ferritin level assessment and echocardiography was performed to evaluate their cardiac function. Data were statistically analysed using the Chi-square test. Results: The mean age of patients was 7.24±2.76 years and the age range was 1-12 years. Mean serum ferritin levels in the study was 1938.67±992.57 and more than three-fourth of our population had serum ferritin levels more than 1000 ng/ mL. A 30% of present study population had abnormal echo findings. A significant correlation was noted between serum ferritin levels and echo parameters like Fractional Shortening (FS), Deceleration Time (DT), Early and Late Ratio (E/A ), Left Ventricular Mass (LV Mass). But negative correlation was found between serum ferritin levels and Ejection Fraction (EF). Conclusion: The present study concluded that due to the significant correlation between serum ferritin levels and echocardiographic parameters, it is beneficial to conduct echocardiography in all patients of beta thalassaemia major in their first decade to gain a better understanding of cardiac function.