ECHOCARDIOGRAPHIC EVALUATION OF CARDIAC-FUNCTION IN MULTITRANSFUSED NONCHELATED CHILDREN WITH THALASSEMIA

Left ventricular functions were studied by two-dimensional, M-mode, an d Doppler echocardiography in 25 multitransfused, nonchelated patients with beta-thalassemia major (group I) and in 15 age-matched healthy c hildren (group II). Hemoglobin levels in the patients had been maintai ned at over 9gm/dl, and none of them had overt evidence of cardiac fai lure. The mean ejection fraction (EF) was significantly lower in group I (P<.05). The ratio of early diastolic wave (E) to atrial filling wa ve (A) i.e., EA ratio was significantly greater (P<.05). Although the mean deceleration time (DT) in group I was greater, the difference was not statistically significant. The prolongation of DT correlated posi tively with the number of transfusions and the serum ferritin level. T he mean systolic and diastolic left ventricular volumes were greater i n those with serum ferritin in excess of 2500 ng/ml. Noninvasive, echo cardiographic evaluation is helpful in identifying cardiac dysfunction in asymptomatic thalassemic patients.