الفهرس 
AbstractOnly 14 pages are availabe for public view
 |  | from | 217 |  |  |
| | | from | 217 | | |
Abstract
Background: The main factor involved in the pathophysiology of cardiac dysfunction in β-thalassemia patients is iron overload. Objectives: The present study aimed to study the cardiac complications in children with beta thalassemia major by measuring cardiac function through Echocardiographic examination and 24 hours ambulatory holter. Patients and Methods: This study was conducted on 40 children with beta thalassemia including 22 male and 18 female with their age range from 1–18 with mean age value of 9.24 ± 4.01 years who were admitted to Hematology Unit, Pediatric Department, Tanta University Hospital (group I), ,and 40 healthy children including 18 male and 22 female (group II) with mean age value 7.88 ± 3.82 they were subjected to complete clinical evaluation including anthropometric data, laboratory investigations including CBC,serum ferritin, HPLC, liver, renal functions, Echocardiogram examination and 24 hours ambulatory holter. Results: 52.5% of patient group have no arrhythmia, 47.5% of patient group have arrhythmia. Hepatomegaly, splenectomy, splenomegaly, pallor, jaundice and mongoloid facies were most common presenting clinical data in patient group. Weight, height, body mass index were lower in patient group than control group. Serum ferritin was significantly higher in patient group especially subgroup who had arrhythmia, 57.8% of patients with arrhythmia have irregular chelating therapy , left ventricular ejection fraction and left ventricular fraction shortening were significantly lower in patient group than control group , Peak mitral annular systolic velocity (S’) was significantly lower in patient group than control group , E`/A `ratio was significantly higher in patient group than control group, 47.5% of patient group had arrhythmia,32.5 %had sinus tachycardia, duration of P-R interval was higher in patient group than control group ,R in channel 1 , R in channel 2 and duration of QRS complex were significantly higher in patient group, QT corrected was significantly higher in patient group than control group , time domain (SD-24 Hour, SDANN index, SDNN index, Rmssd, Pnn50) was significantly lower in patient group than control, low frequency domain is lower in patient group than control group, high frequency domain was significantly higher in patient group than control group. Conclusions: iron overload and irregularity of iron chelating therapy had a major role in cardiac affection in thalassemic patients. Recommendations: Children with thalassemia major should undergo meticulous follow up as regard regular blood transfusion, regular iron chelators in a proper manner and doses. Routine Echocardiogram and 24 ECG holter every 6 months for early detection of any cardiac affection.