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Evaluation of electrocardiographic markers of cardiac arrhythmic events and their correlation with cardiac iron overload in patients with β-thalassemia major

Published online by Cambridge University Press:  04 September 2020

Tulay Demircan Open the ORCID record for Tulay Demircan [Opens in a new window] ,
Zuhal Onder Sivis ,
Burçak Tatlı Güneş  and
Cem Karadeniz Open the ORCID record for Cem Karadeniz [Opens in a new window]
Tulay Demircan*
Affiliation:
Department of Pediatric Cardiology, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
Zuhal Onder Sivis
Affiliation:
Department of Pediatric Hematology, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
Burçak Tatlı Güneş
Affiliation:
Department of Pediatric Hematology, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
Cem Karadeniz
Affiliation:
Department of Pediatric Cardiology Unit, Izmir Katip Celebi University, Izmir, Turkey
*
Author for correspondence: Tulay Demircan, Department of Pediatric Cardiology, Izmir Tepecik Training and Research Hospital, Izmir, Turkey. Tel: +90 505 753 87 60; Fax: 0232 433 07 56. E-mail: [email protected]
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Abstract

Iron overload is associated with an increased risk of atrial and ventricular arrhythmias. Data regarding the relationship between electrocardiographic parameters of atrial depolarisation and ventricular repolarisation with cardiac T2* MRI are scarce. Therefore, we aimed to investigate these electrocardiographic parameters and their relationship with cardiac T2* value in patients with β-thalassemia major. In this prospective study, 52 patients with β-thalassemia major and 52 age- and gender-matched healthy patients were included. Electrocardiographic measurements of QT, T peak to end interval, and P wave intervals were performed by one cardiologist who was blind to patients’ data. All patients underwent MRI for cardiac T2* evaluation. Cardiac T2* scores less than 20 ms were considered as iron overload. P wave dispersion, QTc interval, and the dispersions of QT and QTc were significantly prolonged in β-thalassemia major patients compared to controls. Interestingly, we found prolonged P waves, QT and T peak to end dispersions, T peak to end intervals, and increased T peak to end/QT ratios in patients with T2* greater than 20 ms. No significant correlation was observed between electrocardiographic parameters and cardiac T2* values and plasma ferritin levels. In conclusion, our study demonstrated that atrial depolarisation and ventricular repolarisation parameters are affected in β-thalassemia major patients and that these parameters are not correlated with cardiac iron load.

Keywords

Thalassemiairon overloadred blood cellselectrocardiography
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 11 , November 2020 , pp. 1666 - 1671
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Copyright
© The Author(s), 2020. Published by Cambridge University Press

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