The Prevalence of Adrenal, Parathyroid and Cardiac Dysfunction in Patients with Beta Thalassemia Major

Abstract

<span style="font-family:;"><span>Background:</span><span> Adrenal and parathyroid insufficiency are uncommon in patients with transfusion dependent Beta Thalassemia (<i>β</i>-TM). Further, myocardial echocardiographic abnormalities are recognized but with a variable outcomes Aim: The aim is to determine the prevalence of adrenal and parathyroid insufficiency in patient with transfusion de</span><span>pendent</span><span> </span><i><span>β</span></i><span>-TM.</span><span> </span><span>And to assess left ventricle systolic and diastolic function using Pulsed Doppler (PD) and Tissue Dop</span><span>pler (DT) echocardiogram</span><span>. </span><span>Methods:</span><span>The study was conducted on patients with <i>β</i>-TM (n = 99, age 15.92</span><span> </span><span>±</span><span> </span><span>8.92 years) and compared with an age-matched controls (n = 98 age 15.79</span><span> </span><span>±</span><span> </span><span>8.94 years). In all participants echocardiographic indices of M mode and PD and TD were performed. Blood samples were withdrawn for measuring the serum cortisol, parathyroid and Ferritin. Correlation between the level of cortisol and ferritin level was evaluated. Results: Patients with</span><span> </span><i><span>β</span></i></a><span>-TM compared with controls, ha</span><span>d</span><span> significantly thicker LV septal wall index of 0.65</span><span> </span><span>± 0.26 <span>vs</span> 0.44</span><span> </span><span>± 0.2190, p</span><span> </span><span><</span><span> </span><span>0.001 and LV posterior wall of 0.65 ± 0.235 <span>vs</span> 0.43 ± 0.214, p</span><span> </span><span>< 0.001, with no significant dilation of LV cavity in systole and diastole. The systolic function of LVFE% was normal of 51.95</span><span> <span style="font-family:'Times New Roman','serif';font-size:10pt;"><span> ±</span></span><span style="font-family:'MS Mincho';font-size:10pt;"> </span></span><span>5.5 <span>vs</span> 5.0</span><span> <span style="font-family:'Times New Roman','serif';font-size:10pt;"><span> ±</span></span></span><span> </span><span>5.6, p</span><span> </span><span>=</span><span> </span><span>0.23. Furthermore patients with <i>β</i>-TM ha</span><span>d</span><span> higher E/A ratio (1.54</span><span> </span><span>±</span><span> </span><span>0.18 <span>vs</span> 1.23</span><span> </span><span>±</span><span> </span><span>0.17, p</span><span> </span><span><</span><span> </span><span>0.01) and shorter deceleration time (DT) (170.53</span><span> </span><span>±</span><span> </span><span>13.3 <span>vs</span> 210.50</span><span> </span><span>±</span><span> </span><span>19.20 m sec, p</span><span> </span><span><</span><span> </span><span>0.01). The ratio of transmitral E wave velocity to the tissue Doppler E wave at the basal septal mitral annulus (E/Em) was significantly higher in <i>β</i>-TM group (19.68</span><span> </span><span>±</span><span> </span><span>2.81 <span>vs</span> 13.86</span><span> </span><span>±</span><span> </span><span>1.41, p</span><span> </span><span><</span><span> </span><span>0.05). ...