Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Pediatrics

Heart disease remains the major cause of morbidity and mortality in thalassemic patients. Multiple pathologies have been suggested in the development of cardiac dysfunction in thalassemic patients including: iron overload in the heart, leading to RV diastolic then LV systolic dysfunction, chronic anemia and the tissue hypoxia it induces together with impair free fatty acid oxidation and ATP production in myocardial cells. Because congestive heart failure is the main cause of death in these patients, early recognition of cardiac dysfunction may be useful in modifying the therapy. Tissue doppler echocardiography and serum troponin level may be a promising tool for such a purpose. Thirty thalassemic patients with a mean age of 12.93±2.07 years and thirty aged matched healthy control subjects have been included in the study. Patients have been recruited from pediatric hematology clinics in both Cairo university. Conventional, TDI as well as conventional and M-Mode echogardiography was performed to all patients and control subjects in addition to myocardial relaxometry T2* by cardiac MRI and serum assays of troponin. Though no statistically significant difference was noted between cases and controls by conventional echocardiographic parameters, compared to normal subjects, we found by tissue doppler imaging that there is significant difference of Rv e'/a' ratio between cardiac and non-cardiac iron overloaded patients which reflects early diastolic dysfunction in cardiac iron overloaded patients

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