Prevalence of pulmonary hypertension in non-transfusion-dependent thalassemia patients at tertiary level hospital in Bangladesh

Objectives: Non-transfusion-dependent thalassemia (NTDT) can present from mild symptoms with minimal anemia to more severe cases that require blood transfusion. However, NTDT patients are often complicated with pulmonary hypertension (PH, according to the Echocardiographic Guideline for PH (American Society of Echocardiography), which increases the risk of heart failure and death if left untreated. The study aimed to evaluate the prevalence of PH in NTDT patients in Bangladesh, along with their clinical and hematological parameters. Material and Methods: This cross-sectional exploratory study recruited 50 beta NTDT patients visiting the indoor and outdoor facilities of the Department of Hematology and Bone Marrow Transplant Unit, Dhaka Medical College Hospital, Dhaka. After obtaining consent, the data of NTDT patients were collected from the patients’ questionnaires and medical reports. Non-invasive cardiac investigations, i.e., electrocardiography, Color Doppler echocardiography, and chest X-ray, were performed. Results: The median age of the 50 NTDT patients was 22 years (interquartile range = 8 years). The study revealed that 10% of the study participants were pulmonary hypertensive patients whose mean±SD age was 26.2±5.01 years. The current mean hemoglobin level in the patients with and without PH differs significantly (7.73 ± 0.545 g/dL vs. 8.44 ± 0.350 g/dL, respectively, P < 0.001). Moreover, the tricuspid regurgitant jet velocity differs significantly between the NTDT patients with and without PH ( P < 0.001). Conclusion: The findings of the preliminary study present the prevalence of PH in NTDT patients in Bangladesh, which emphasizes taking faster diagnostic approaches to ease early intervention and minimize the risk of subsequent complications in the patients.