Assessment of ventricular dysfunction in Egyptian children with Beta-thalassemia major

Objective/Background: The purpose of this study was to evaluate serum cardiac troponin I and serum N-terminal (NT) pro-brain natriuretic peptide (pro-BNP) levels and the utility of tissue Doppler imaging in assessing cardiovascular changes following left ventricular (LV) dysfunction in children with beta-thalassemia major (β-TM). In children with β-TM who depend on regular blood transfusion, cardiac iron toxicity is a common serious complication. The most common cause of death among these patients is congestive heart failure. Methods: This is a cross-sectional study which included 50 patients with β-TM and 50 healthy controls. Tissue Doppler imaging was performed and levels of serum ferritin, cardiac troponin I, and NT pro-BNP were estimated for all included patients. Results: Serum NT pro-BNP and cardiac troponin (cTnI) showed a significant increase in patients with β-TM ( p < .001). In patients with β-TM, LV dimensions (LV end systolic diameter) and (LV end diastolic diameter) were large ( p < .01); LVmass ( p < .01), Ewave, and E/A ratio ( p < .01) were high ( p < .05); and deceleration time was short ( p < .05). Besides, transmitral ratio (E/E m ) ( p < .05) and tricuspid valve velocity were higher ( p < .05), and early diastolic velocity (E m )( p < .05) and systolic wave velocity (S m ) were lower in patients with β-TM( p < .05). Asignificant positive correlation was detected between the pro-BNP and Ewave ( r = 0.558, p < .001), E/A ratio ( r = 0.403, p < .001), E/E m ratio ( r = 0.576, p < .001), and ferritin ( r = 0.545, p < .001). Conclusion: Pulsed wave tissue Doppler imaging and NT pro-BNP had a significant role in the estimation of ventricular dysfunction in children with β-TM.