Heart failure in beta thalassemia: a 5-year follow-up study

Purpose To evaluate the survival of patients with beta thalassemia and heart failure who were treated with iron chelation therapy. Subjects and methods Fifty-two consecutive patients with beta thalassemia and heart failure were followed in a prospective 5-year study. All patients underwent a full clinical examination with chest radiograph, electrocardiogram, and echocardiographic investigation performed at 6-month intervals or when a new symptom developed. Results Of the 52 patients (mean [± SD] age, 24 ± 5 years), 25 (48%) survived 5 years after the onset of heart failure. Forty-three patients had left-sided heart failure, and 9 had right-sided heart failure. Those with left-sided heart failure were younger at presentation with heart failure (22 ± 4 years vs. 31 ± 6 years; P<0.001), had lower ejection fractions (36% ± 9% vs. 64% ± 10%; P<0.001), and had a lower mean serum ferritin level (3355 ± 1241 ng/mL vs. 6,397 ± 1,613 ng/mL; P<0.001). Conclusion The 5-year survival rate in patients with beta thalassemia with heart failure was greater than previously reported. There are clinical characteristics that may make patients more likely to develop left- or right-sided heart failure.