The correlation between ferritin levels and QTc interval in children with transfusion dependent thalassemia

Heart failure caused by cardiac iron overload is the primary cause of death for thalassemia dependent-transfusions (TDTs) patients. Cardiac iron overload can cause congestive heart failure by oxidative stress. The standard examination for detecting cardiac iron overload is MRI T2*, but it is costly and not available in most hospitals. Prolonged QTc interval on an electrocardiogram (ECG) can serve as an alternative for screening cardiac iron overload in TDTs patients. The aim of this study was to analyze the correlation between ferritin levels and QTc interval prolongation in TDTs patients.This work was a cross-sectional study on TDTs patients aged 7-18 years at Dr. Soetomo General Academic Hospital Surabaya, Indonesia, conducted in 2024, through consecutive sampling and blood transfusions must be given every 2-4 weeks. We evaluated ferritin serum levels by Vidas ferritin, and we evaluated QTc intervals by ECG. Ferritin levels were divided into 1.000-2.500 ng/mL and ≥ 2.500 ng/mL. The QTc interval was divided into normal ( 0.440 s); borderline (0.440-0.460 s); and prolonged ( 0.460 s). Data were analyzed using a two-tailed Spearman test with significance set at p 0.05.Of the 36 participants, 19 were females, with a median age of 11 years (range: 7-17). The median ferritin level was 3.284.2 ng/mL (range: 1.044.9-9.080.0 ng/mL). The median QTc was 0.45 (range: 0.392-0.517) seconds. The result of correlation test between ferritin levels and QTc interval showed p-value of 0,014.There was a statistically significant relationship between ferritin levels and QTc interval.