Key result
Subclinical cardiac dysfunction affects ~79% of children with beta-thalassemia major, linked to iron overload.
Why the study?
Cardiovascular disease remains the leading cause of mortality among children with beta-thalassemia major despite advancements in chelation therapy, necessitating estimation of subclinical cardiac dysfunction prevalence and associated risk factors.
What is the prevalence of subclinical cardiac dysfunction and its associated risk factors in children with transfusion-dependent beta-thalassemia major?
Cross-Sectional (n=77)
No
What is the prevalence of subclinical cardiac dysfunction and its associated risk factors in children with transfusion-dependent beta-thalassemia major?
Subclinical cardiac dysfunction is highly prevalent in children with transfusion-dependent beta-thalassemia major, strongly predicted by advancing age, transfusion burden, and iron overload.
May support enhanced cardiac surveillance in pediatric beta-thalassemia major; hypothesis-generating for risk-factor modification trials.
Introduction: Despite advancements in chelation therapy, cardiovascular disease remains the leading cause of mortality among children with beta-thalassemia major (B-TM). Objective: To estimate the prevalence of subclinical cardiac dysfunction in children with B-TM and to identify associated clinical and biochemical risk factors. Methods: This cross-sectional study was conducted over an 18-month period at a tertiary care institute in Central India. Using consecutive sampling, 77 children with B-TM (aged 2–18 years) were enrolled. Comprehensive data were collected, including demographic profiles, transfusion history, and clinical parameters. All participants underwent hematological and biochemical investigations, electrocardiography, conventional echocardiography, and tissue Doppler imaging (TDI), in accordance with the American Society of Echocardiography guidelines. The Tei Index calculated by TDI was used to assess cardiac function, with elevated values indicating dysfunction. Statistical analysis included Chi-square test, independent t-test, and multivariate logistic regression, with P < 0.05 considered statistically significant. Results: The prevalence of subclinical cardiac dysfunction was 79.2%. All affected children had left ventricular dysfunction, while 64.9% also had right ventricular involvement. A prolonged corrected QT interval was observed in 29.9% of participants and cardiomegaly in 55.8%. Children with cardiac dysfunction were significantly older and had higher transfusion burden ( P < 0.0001). They also exhibited higher systolic blood pressure, lower hemoglobin levels, and elevated serum ferritin levels. Multivariate analysis identified age (odds ratio [OR]: 3.35), total number of transfusions (OR: 1.18), annual blood requirement (OR: 1.06), and serum ferritin (OR: 1.00) as independent predictors of cardiac dysfunction. Conclusion: Subclinical cardiac dysfunction is highly prevalent (79.2%) in children with B-TM. The findings emphasize that advancing age, transfusion burden, and iron overload (serum ferritin) are critical independent risk factors. Early screening using the Tei Index may facilitate timely identification and management of these high-risk pediatric patients.
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Meshram et al. (2026) conducted a cross-sectional in beta-thalassemia major (B-TM) (n=77). Advancing age, transfusion burden, and iron overload was evaluated on Prevalence of subclinical cardiac dysfunction assessed by the Tei Index. Subclinical cardiac dysfunction was highly prevalent (79.2%) in children with beta-thalassemia major, with advancing age, transfusion burden, and iron overload serving as independent risk factors.
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