Influence of High Dose of IV Desferal on Cardiac Complications of Thalassemic Patients

Background and This study was undertaken to determine the effects of high dose IV desferal on symptoms, LV size and function in thalassemic patients 15 thalassemic patients with cardiomyopathy all of whom were on cardiotonic drugs for at least one month, aged between 15-25 yr, with ferritin> 1200ng/ml and Hb>9gr/dl were included in the study. They recieved IV desferal of 130mg/kg/day (max 5gr) during 10-14 hr for 5 consequtive days. Cardiac evaluation including history, plysical exam, ECG and Echocardiography were performed just before recieving desferal, 2 days and one month after completing the regimen. In additon visual and auditory consultations were done before and after the intervention to detect probable side effects. By administering high dose IV desferal, the cardiovascular symptoms reduced considerably and systolic function showed significant improvement so that a reduction in LVEF from 49.1 ± 1.8% to 58/8 ± 2.9% at first follow up and to 57.8 ± 2.1% at second follow up was observed. EPSS decreazed from 9.6 ± 0.8 mm to 6.7 ± 0.8 mm at first follow up and to 6.5 ± 0.6 mm at second follow up (p<0.001). However, there was no significant effect on diastolic function, ECG and physical findings. No remarkable visual and auditory side effects were demonstrated. Based on the data it can be concluded that high dose IV desferal has improving effects on thalassemic cardio myopathy with high ferritin level.