Early detection of cardiac dysfunction and arrhythmia in clinically asymptomatic children with beta thalassemia

Background The main factor involved in the pathophysiology of cardiac dysfunction in beta thalassemia (β-thalassemia) patients is iron overload. Aim This study aimed to detect any cardiac dysfunction or arrhythmia in clinically asymptomatic children with β-thalassemia. Patients and methods This cross-sectional study was carried out on 40 children aged from 1 to 18 years old, both sexes, with β-thalassemia major (β-TM) (group I) and 40 healthy children as a control group (group II). All patients were subjected to echocardiogram examination and 24 h ambulatory Holter device; DMS 300-3A recorder and Cardioscan CS12 software (DM software Inc., USA) 16:56. Results Serum ferritin, reticulocyte, and early to late diastolic trans mitral flow velocity ratio were significantly higher in-β-TM group than control group ( P <0.05). Minimum, maximum heart rate, duration, dispersion of P wave, R in channels 1 and 2, duration of (QRS and P–R interval), QT corrected, and high frequency domain were significantly higher in β-TM group than control group ( P <0.05). Standard deviation (SD) of normal-to-normal inter beat intervals index and root mean square of successive differences between normal heartbeats were significantly lower in β-TM group than control group ( P <0.05). The regularity of chelating therapy was significantly higher in group IB than group IA ( P <0.05). Serum ferritin was significantly higher in group IA than in group IB ( P <0.05). QT corrected was significantly higher in group IA than group IB. Conclusions Iron overload and irregularity of iron chelating therapy had a major role in cardiac affection in thalassemic patients.