Cardio-protective effect of regular transfusion in children with non-transfusion dependent thalassemia (NTDT): A cohort study

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Khalfan Al Senaidi
Surekha Maveda
Niranjan Joshi
Hanan Nazir
Mohamed Elshinawy
Shoaib AL Zadjali
Abdulhakim Al Rawas
Islam Elghamry
Yasser Wali
Doaa Khater

Keywords

non-transfusion dependent thalassemia (NTDT), regular blood transfusion, echocardiography.

Abstract

Background and aim of the work:


 Cardiac complications occur in patients with non-transfusion dependent thalassemia (NTDT). The study aimed to evaluate transfusion effect on systolic and diastolic cardiac function in young NTDT patients. 


Methods: 


Study design: Cohort study.


Seventeen regularly-transfused patients with NTDT (12.5±5.3 years; group 1) and 15 none/minimally transfused patients (13.2±4.8 years; group 2) were followed up for 5 years and compared as regards their clinical parameters, echocardiographic and Tissue-Doppler-Imaging.


Results: Group 2 patients had significantly higher peak late-diastolic velocity of the left-ventricular-inflow Doppler (Am). Mitral-valve A-wave duration/pulmonary-veins, A-wave duration-ratio and pulmonary-vein S/D velocities-ratio were larger in group 2 as well (p = < 0.01). The diameters of right and left outflow-tract were larger with a higher cardiac-index in patients of group 2. Systolic-function was similar in the 2 studied groups.


Conclusion:


Diastolic function assessment revealed indicators of an abnormal relaxation of left-ventricle in non-transfused patients, which suggests a diastolic dysfunction. An increase in the diameter of the outflow-tract is likely attributed to high cardiac-output status in non-transfused NTDT patients as they have a higher cardiac index. Early start of regular transfusion for NTDT patients might prevent serious long-term cardiac complications.

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