TO STUDY RIGHT VENTRICLE (RV) AND LEFT VENTRICLE ( LV) DYSFUNCTION IN TRANSFUSION DEPENDENT BETA THALASSEMIA CHILDREN AT TERTIARY CARE HOSPITAL IN NORTH WEST RAJASTHAN

Abstract

Background- Regular blood transfusions used for long term survival in  ß-thalassemia major patients cause a secondary state of tissue iron overload. Myocardial iron deposition can result in cardiomyopathy, and heart failure remains the leading cause of death. This study was planned to see the Right Ventricle (RV) and Left Ventricle(LV)dysfunction in beta thalassemia  transfused patients.

Method- Patients of ß thalassemia major above 2 years of age received regular blood transfusions at least for 1 year duration, attending OPD in the Department of Pediatrics, S P Medical College, Bikaner were included.Echo  was  correlated with serum ferritin Level(SFL).

Results- Tissue Doppler imaging(TDI) parameters of 50 patients at mitral annulus e.g. Em septal, Em Lateral, Am septal, Am lateral, Sm Septal and Sm Lateral were abnormal(<2SD and >2SD)in 70% & 0%, 50% & 4%, 10% & 46%, 34% & 24%, 40% & 22% and 60% & 10% patients respectively.TDI parameters at tricuspid valvee.g. Et, At and St were abnormal(<2SD)in 98%, 96% and 98% patients respectively. The differences in mean values of Et, At and St, when compared in the SFL groups <2500,2500-5000 and>5000, was non significant(p>0.05).

Conclusion- TDI is superior to conventional echocardiography in giving an early evidence of diastolic myocardial dysfunction in asymtopmatic and normal LV function patients.TDI can be applied as an integrated part of assessment of children & adolescents with ß-thalassemia. Septal Sm, Em & lateral Em, Sm, Am and RV Et, At, St were reduced early in majority of patients. Our study showed early involvement of septum and RV in thalassemic patients.

Key Words: ß-thalassemia major ;Right Ventricle (RV) and Left Ventricle ( LV) dysfunction; Echocardiogram ;Tissue Doppler Imaging