Abstract
Beta thalassemia is an autosomal, recessive disorder, characterized by ineffective
erythropoiesis. Chronic transfusions and inability of body to eliminate iron lead
to an iron overload, thereby causing damage to heart. Natriuretic peptides (NPs) are
produced within the heart, which are then released into the circulation in response
to ventricular wall stress. We, therefore, aimed to study the relation between ventricular
dysfunction and N-terminal pro-B-type natriuretic peptides (NT-proBNPs). We enrolled
105 patients with increased serum ferritin levels and echocardiography was performed.
We collected blood samples and NT-proBNP levels were measured in them. Though we found
that the studied group had no significant difference in the mean serum NT-proBNP levels,
in patients with or without hypertrophy (n = 37, p = 0.992), the NT-proBNP levels were found to be significantly increased in patients
with diastolic dysfunction (n = 24, p < 0.0001 with mean values of 577.67 ± 122.01 and 456.50 ± 48.40 pg/mL in patients
with and without diastolic dysfunction, respectively). The NT-proBNP levels correlated
well with the echocardiography indices, such as left ventricular end-systolic diameter
(LVESD), ratio between early mitral inflow velocity and mitral annular early diastolic
velocity (E/E' ratio), and ratio of the early (E) to late (A) ventricular filling
velocities (E/A ratio), and were found to have significant positive correlation with
the serum ferritin levels. The NT-proBNP levels correlated significantly with diastolic
dysfunction; thus, serum ferritin levels could be useful for assessing the diastolic
dysfunction in patients with beta thalassemia.
Keywords
NT-proBNP - diastolic dysfunction - thalassemia major
