THE CORRELATION OF RELATIVE WALL THICKNESS, LV MASS/LV MASS INDEX, CARDIAC INDEX AND PCWP IN RELATION TO SERUM FERRITIN IN TRANSFUSION DEPENDENT BETA THALASSMEIC CHILDREN IN NORTH WEST RAJASTHAN

Abstract

Objective: Regular blood transfusions used for long term survival in ß-thalassemia major patients cause a secondary state of tissue iron overload. Myocardial iron deposition can result in cardiomyopathy, and heart failure remains the leading cause of death. This study was planned to see the correlation of Relative Wall Thickness (RWT), LV Mass, Cardiac Index(CI)  and pulmonary capillary wedge pressure(PCWP) in relation to Serum Ferritin in transfusion  dependent  Beta Thalassemia children.

Methods: Patients of ß thalassemia major above 2 years of age received regular blood transfusions at least for 1 year duration, attending OPD in the Department of Pediatrics, S.P. Medical College, Bikaner were enrolled. Echo findings of 50 cases were correlated with serum ferritin level(SFL).

Result: Mean RWT in SFL group <2500ng/ml was 0.40±0.09, in SFL group 2500-5000 ng/ml, it was 0.41±0.08 and in SFL group >5000 ng/ml, it was 0.49±0.09; p value>0.05. Mean LV mass in SFL group <2500 was 68.76±24.32, in SFL group 2500-5000, it was 90.07±24.18 and in SFL group >5000, it was 123.06±42.42. The difference was found statistically highly significant (p<0.001). Mean PCWP in SFL group <2500 was 11.55±1.53, in SFL group 2500-5000, it was 12.02±2.06 and in SFL group >5000, mean PCWP was 13.31±2.09;p value>0.05. Mean CI in SFL group <2500 was 5.24±0.99, in 2500-5000 group was 5.79±1.07 and in SFL group >5000, it was 5.91±1.26 ; p value>0.05.

Conclusion: There was significant positive correlation of serum ferritin level only with LV Mass.Relative Wall thickness, PCWP and cardiac index were insignificantly correlated. .

Keywords: ß-thalassemia major; Relative wall thickness, LV mass/ LV mass index, cardiac index, PCWP, Echocardiogram; Tissue Doppler Imaging