Correlation of serum ferritin levels, echocardiography parameters, and cardiac magnetic resonance imaging with T2 weighting in patients with beta-thalassemia major

Beta thalassemia often leads to iron overload in various tissues, including the heart. Current diagnostic methods rely on MRI, which may not be feasible in certain situations. This study aimed to investigate the correlation and diagnostic accuracy between serum ferritin levels, echocardiography results, and T2-weighted cardiac MRI values in patients with beta-thalassemia major to diagnose myocardial iron overload without the necessity of MRI.

This cross-sectional study included 102 patients with beta-thalassemia major who underwent echocardiography and MRI. Serum ferritin levels were measured, and myocardial T2 weighting was calculated. The cut-off values for MRI interpretation were defined as T2>20 milliseconds for normal myocardial iron load, T2*≤2010 milliseconds for mild to moderate myocardial iron burden, and T2*≤10 for severe myocardial iron burden.

The mean ferritin level was 2418.7±2860.8 ng/ml, mean heart T2* was 22.6±14.7 ms, and mean ejection fraction (EF) based on MRI was 51.7±11.2%. The echocardiographic parameter MVDT was identified as a suitable diagnostic indicator for reduced and severely reduced T2*. The sensitivity and specificity of ≤170 MVDT for T2 reduction were 0.72 and 0.62, respectively, and the sensitivity and specificity of ≤150 MVDT for severely reduced T2 were 0.52 and 0.96, respectively.

The findings suggest that serum ferritin levels, EF, and MVDT in echocardiography have the highest diagnostic efficiency for detecting reduced T2*. In settings where cardiac MRI is unavailable or contraindicated, the MVDT parameter and ferritin levels can be valuable for evaluation purposes.