Evaluation of Cardiac Systolic and Diastolic Function by Echocardiographic Tei Index in Thalassemic Patients Referring to Hazrate Masoumeh Hospital, Qom, Iran, 2012-2013

Early diagnosis of secondary cardiac involvement due to iron overload is very important in thalassemia patients. The aim of this study was to evaluate cardiac systolic and diastolic function by Tei Index in patients with β-thalassemia. This descriptive cross-sectional study was conducted on 64 transfusion dependent major and intermediate β-thalassemia patients referring to Hazrate Masoumeh Hospital from 2012-2013. The relevant parameters measured were as follows: Myocardial performance index (Tei Index), ejection fraction, current ferritin, mean ferritin of past three years, hemoglobin, and the age of starting blood transfusion and chelation therapy. Data were analyzed using Chi-square, Mann-whitney, and Spearman correlation. p<0.05 was considered statistically significant. Three patients (6.2%) with major thalassemia had a mild systolic dysfunction, whereas it was absent in patients with intermediate thalassemia. 43 patients (93.8%) with major thalassemia and 16 patients (100%) with intermediate thalassemia had diastolic dysfunction. In this study a statistically significant correlation was found between the age of starting chelation therapy and diastolic dysfunction. No significant relationship was found between Tei Index and gender, current ferritin, age of starting transfusion, and hemoglobin. According to the results of this study, the earliest sign of cardiac dysfunction due to iron overload in thalassemic patients was diastolic dysfunction. Regarding significant correlation between the age of starting chelation therapy and diastolic dysfunction, it seems that diastolic dysfunction can be delayed by starting chelation therapy in younger ages.