CORRELATION BETWEEN SERUM FERRITIN LEVELS AND CARDIAC DYSFUNCTION IN CHILDREN WITH TRANSFUSION-DEPENDENT Β-THALASSEMIA MAJOR

Abstract

Background:

Children with transfusion-dependent β-thalassemia major require frequent blood transfusions for the rest of their lives, which greatly raises the risk of iron buildup and consequent heart problems. For determining the total body iron burden, serum ferritin is frequently utilised as a readily available marker.

Objective:

To assess the correlation between echocardiographic markers of cardiac impairment and serum ferritin concentrations in pediatric patients with transfusion-dependent β-thalassemia major.

Methods:

Between January and December 2024, 82 children with transfusion-dependent β-thalassemia major who were two years of age or older participated in a cross-sectional study at Lady Reading Hospital in Peshawar. Everybody had undergone at least ten transfusions throughout their lifetime. Three pre-transfusion measurements were averaged to determine serum ferritin levels. Echocardiography was used to examine cardiac function, including the E/A ratio, fractional shortening (FS), and ejection fraction (EF).

Results:

There were 46 male (56.1%), with a median age of 9 years (IQR: 3–16). Median serum ferritin was 3,856 ng/mL (IQR: 1,245-14,567). A strong positive correlation was seen between transfusion frequency and serum ferritin levels (r = 0.72, p < 0.001).

Four out of eighty-two patients (4.9%) had dilated cardiomyopathy on echocardiography. The E/A ratio was 1.72 (SD 0.42), the FS was 35 (SD 6.23), and the mean EF was 68 (SD 12.45). Serum ferritin had a positive correlation with the E/A ratio (r = 0.64, p < 0.001) and a negative correlation with EF (r = -0.75, p < 0.001) and FS (r = -0.62, p < 0.001).

Conclusion:

Elevated serum ferritin levels were linked to both systolic and diastolic dysfunction as identified through echocardiographic assessment. Routine monitoring and appropriate adjustment of chelation therapy may help reduce cardiac risk in patients with transfusion-dependent β-thalassemia.