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Heart rate variability in β-thalassaemia major with or without cardiac siderosis

Published online by Cambridge University Press:  12 February 2013

A. Alp ,
O. Ozdogan ,
C.C. Guloglu ,
M. Turker  and
B. Atabay
A. Alp*
Affiliation:
Department of Internal Medicine, Tepecik Training and Research Hospital, Yenisehir, Izmir, Turkey
O. Ozdogan
Affiliation:
Department of Cardiology, Tepecik Training and Research Hospital, Yenisehir, Izmir, Turkey
C.C. Guloglu
Affiliation:
Department of Internal Medicine, Tepecik Training and Research Hospital, Yenisehir, Izmir, Turkey
M. Turker
Affiliation:
Department of Pediatric Hematology, Tepecik Training and Research Hospital, Yenisehir, Izmir, Turkey
B. Atabay
Affiliation:
Department of Pediatric Hematology, Tepecik Training and Research Hospital, Yenisehir, Izmir, Turkey
*
Correspondence to: Dr A. Alp, Adnan Menderes University Medical Faculty Hospital, Division of Nephrology, 09000 Aydin, Turkey. Tel: +90 256 444 1 256/2020; Fax: +90 256 214 4086; E-mail: [email protected]
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Abstract

Objectives

Iron cardiomyopathy remains the major cause of death in β-thalassaemia major. Excessive iron loading could lead to cardiac dysfunction and arrhythmias. Reduced heart rate variability is associated with a higher risk of arrhythmia and sudden death after myocardial infarction and heart failure. Previous data have reported on reduced heart rate variability in patients with marked cardiac iron accumulation. In this study, we compared heart rate variability among β-thalassaemia major (TM) patients with or without cardiac siderosis.

Methods

Out of 70 β-thalassaemia major patients with preserved ejection fractions, 38 patients with cardiac T2* magnetic resonance imaging assessment were included in our study. Time domain heart rate variability parameters were analysed from 24-hour recorded electrocardiograms and were compared with the control group.

Results

The mean T2* magnetic resonance imaging value was 22.9 ± 13.3 (4.7–47.5). In 21 patients with β-thalassaemia major, the T2* magnetic resonance imaging values were greater than 20 ms and these patients were considered to be in the early stage of the disease. When we compare these patients with control subjects, the standard deviation of all NN intervals was still significantly lower (133.0 ± 32.2 versus 162.8 ± 32.9, p = 0.001) in β-thalassaemia major patients despite normal T2* magnetic resonance imaging values. On the contrary, the standard deviation of all NN intervals was not correlated with haemoglobin levels in these patients (p > 0.05).

Conclusions

Heart rate variability parameters were reduced even in β-thalassaemia major patients without evident cardiac siderosis, as specified by magnetic resonance imaging data. The results of this study show that reduction of heart rate variability may start before cardiac iron loading is demonstrated by T2* magnetic resonance imaging in β-thalassaemia major.

Keywords

β-Thalassaemia majorcardiac magnetic resonance imagingheart rate variability
Type
Original Articles
Information
Cardiology in the Young , Volume 24 , Issue 2 , April 2014 , pp. 263 - 267
Copyright
Copyright © Cambridge University Press 2013 

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