CARDIAC IRON OVERLOAD IN THALASSEMIC PATIENTS - AN ENDOMYOCARDIAL BIOPSY STUDY

Secondary heart failure induced by organ siderosis is the main cause o f death in patients affected by thalassemia major. At present it canno t be predicted whether heart siderosis is correlated with iron overloa d and little is known about the real cardiac histological pattern of p ost transfusional hemochromatosis in patients with thalassemia major a nd intermedia. The study aim was to evaluate cardiac iron overload by non invasive and invasive techniques. Fifteen thalassemic patients wer e investigated and endomyocardial biopsy performed in ten revealed dif ferent grades of endomyocardial iron overload with histochemical posit ivity. Non invasive techniques are not able to furnish an exact pictur e of the cardiac hemochromatosis. There was a significant correlation between serum ferritin and myocardial iron grade. Patients with elevat ed ferritin levels and poor compliance to chelating therapy are at hig h risk of severe heart hemochromatosis, It was seen that endomyocardia l biopsy is a useful tool in studying myocardial iron.