CARDIO-PULMONARY ASSESSMENT IN PATIENTS WITH BETA THALASSEMIA

Background Objective: Iron overload is the main cause of death in thalassemic patients. Assessment of cardiac and pulmonary functions in transfusion-dependant beta thalassemic patients who were clinically cardiopulmonary free in a trial to establish feasible and applicable parameters to detect those changes at early stages before irreversible dysfunction occurs was done. Patients and Methods 30 beta thalassemia patients (15 thalassemia major and 15 thalassemia intermedia) and 30 controls were enrolled in this study. All subjects were subjected to echocardiography, respiratory functions, arterial blood gases, serum ferritin, and serum iron. Results The mean values of left ventricular end systolic diameter(LVESD), left ventricular end diastolic diameter (LVEDD), end systolic volume (ESV), end diastolic volume (EDV) and aortic root diameter (AR diameter) were statistically significantly higher in patients than in controls. The incidence of tricuspid regurge (TR) in thalassemic patients was statistically significantly higher than the control group (P=0.03). Pulmonary function tests revealed that 40 percent (12 patients) of the studied group exhibited restrictive pattern of respiration. Eighteen (18) patients (60 percent) suffered from hypoxemia. Aprtic root diameter showed significant positive correlation to serum ferritin (r-0.456, P=0.01). Oxygen saturation showed a statistically significant negative correlation with serum iron (r = -0.66, P=0.0001), and serum ferritin (r=0.417, P=0.016) and a statistically significant positive correlation with transfusion free duration (r=0.39, P=0.02), Significant negative relation was also noticed between serum ferritin and forced vital capacity (FVC). Conclusions Thalassemia patients despite being clinically free, suffer from significant cardiopulmonary changes.