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Background: Cardiac iron overload causes severe cardiac complications and is a leading cause of death in beta-thalassemia major (B-TM) patients. T2-weighted cardiovascular magnetic resonance (T2*CMR) can detect preclinical cardiac iron overload. We evaluated the ability of 12-lead electrocardiographic atrial and ventricular depolarization and repolarization parameters to predict cardiac iron loading in TM. Methods: This cross-sectional study was conducted on patients with beta-thalassemia major; all participants underwent a standard 12-lead electrocardiogram during a single study visit, and the depolarization and repolarization parameters of ECG were measured and compared with the cardiac iron level detected by T2*CMR, with a detectable cardiac iron cutoff of T2* less than 20 ms. Results: A total of 26 patients (mean age of 26.19 years, 34.62% male) were included. Mean T2*CMR values were 21.53 ms (46.15%<20 ms, 53.85%≥20 ms). Among ECG parameters, only Pwd, QTc, and QTcd (P values 0.026, 0.030, and 0.006, respectively) were significantly prolonged in patients with T2*<20 ms compared to patients with T2*≥20 ms. There was a statistically negative correlation between T2*CMR, Pwd, and QTcd (P values 0.028 and 0.021, respectively). Moreover, no correlation was found between Tp-e, Tp-e d, JTc, JTcd, Tp-e/QT, Tp-e/JT, Tp-e/JTc, and T2* values. Conclusion: Pwd and QTcd can be used as alternatives to T2*CMR to predict cardiac iron load levels in patients with beta-thalassemia major.
Ghandi et al. (2024) studied this question.