Correlation of Serum Ferritin and Cardiac Iron Toxicity with Cardiac Function in Transfusion Dependent Beta-Thalassemia Major Patients

Background: Cardiac iron toxicity is a major cause of mortality in transfusion-dependent beta-thalassemia major patients. The main modality for detecting cardiac iron toxicity is MRI T2* with limited availability. This study aims to obtain iron toxicity profiles in transfusion-dependent beta-thalass...

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Main Authors: Tubagus Djumhana Atmakusuma, Rajesh Kalwani, Sally Aman Nasution, Cleopas Martin Rumende
Format: Article
Language:English
Published: Interna Publishing 2021-10-01
Series:Acta Medica Indonesiana
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Online Access:http://www.actamedindones.org/index.php/ijim/article/view/1782
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author Tubagus Djumhana Atmakusuma
Rajesh Kalwani
Sally Aman Nasution
Cleopas Martin Rumende
author_facet Tubagus Djumhana Atmakusuma
Rajesh Kalwani
Sally Aman Nasution
Cleopas Martin Rumende
author_sort Tubagus Djumhana Atmakusuma
collection DOAJ
description Background: Cardiac iron toxicity is a major cause of mortality in transfusion-dependent beta-thalassemia major patients. The main modality for detecting cardiac iron toxicity is MRI T2* with limited availability. This study aims to obtain iron toxicity profiles in transfusion-dependent beta-thalassemia patients; to see a correlation between iron toxicity and cardiac function. Methods: We conducted a cross-sectional study at the Adult Thalassemia Polyclinic of Cipto Mangunkusumo Hospital, Indonesia from December 2017 to March 2018. We performed the statistical analysis using Pearson/Spearman Test comparing MRI T2* values with ejection fraction and E/A ratio. Results: The median of 4-months mean of ferritin levels was 5130 ng/mL. The mean for cardiac T2* was 24.96 ms. Severe cardiac hemosiderosis (mean cardiac MRI T2* < 10 ms)  occurred in 11.3% of the subjects.  There was weak correlation between serum ferritin with cardiac iron toxicity (r=-0.272, p=0.032) and ejection fraction (r=-0.281, p=0.013). But, there was no correlation between cardiac iron toxicity with ejection fraction and E/A ratio. Conclusion: Serum ferritin correlated weakly with cardiac iron toxicity and cardiac systolic function. Meanwhile, there was no correlation between cardiac iron toxicity with cardiac systolic and diastolic function.
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publishDate 2021-10-01
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spelling doaj-art-9865a906fe12409bb23c286ad2ca578b2025-08-20T03:50:00ZengInterna PublishingActa Medica Indonesiana0125-93262338-27322021-10-01533Correlation of Serum Ferritin and Cardiac Iron Toxicity with Cardiac Function in Transfusion Dependent Beta-Thalassemia Major PatientsTubagus Djumhana Atmakusuma0Rajesh Kalwani1Sally Aman Nasution2Cleopas Martin Rumende3Division of Hematology-Medical Oncology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Dr. Cipto Mangunkusumo Hospital, Jakarta, IndonesiaDepartment of Internal Medicine, Pantai Indah Kapuk Hospital, Jakarta, IndonesiaDivision of Cardiology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, IndonesiaDivision of Respirology and Critical Care, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, IndonesiaBackground: Cardiac iron toxicity is a major cause of mortality in transfusion-dependent beta-thalassemia major patients. The main modality for detecting cardiac iron toxicity is MRI T2* with limited availability. This study aims to obtain iron toxicity profiles in transfusion-dependent beta-thalassemia patients; to see a correlation between iron toxicity and cardiac function. Methods: We conducted a cross-sectional study at the Adult Thalassemia Polyclinic of Cipto Mangunkusumo Hospital, Indonesia from December 2017 to March 2018. We performed the statistical analysis using Pearson/Spearman Test comparing MRI T2* values with ejection fraction and E/A ratio. Results: The median of 4-months mean of ferritin levels was 5130 ng/mL. The mean for cardiac T2* was 24.96 ms. Severe cardiac hemosiderosis (mean cardiac MRI T2* < 10 ms)  occurred in 11.3% of the subjects.  There was weak correlation between serum ferritin with cardiac iron toxicity (r=-0.272, p=0.032) and ejection fraction (r=-0.281, p=0.013). But, there was no correlation between cardiac iron toxicity with ejection fraction and E/A ratio. Conclusion: Serum ferritin correlated weakly with cardiac iron toxicity and cardiac systolic function. Meanwhile, there was no correlation between cardiac iron toxicity with cardiac systolic and diastolic function.http://www.actamedindones.org/index.php/ijim/article/view/1782cardiac iron toxicityserum ferritinsystolic functiondiastolic functioncardiac MRI T2*
spellingShingle Tubagus Djumhana Atmakusuma
Rajesh Kalwani
Sally Aman Nasution
Cleopas Martin Rumende
Correlation of Serum Ferritin and Cardiac Iron Toxicity with Cardiac Function in Transfusion Dependent Beta-Thalassemia Major Patients
Acta Medica Indonesiana
cardiac iron toxicity
serum ferritin
systolic function
diastolic function
cardiac MRI T2*
title Correlation of Serum Ferritin and Cardiac Iron Toxicity with Cardiac Function in Transfusion Dependent Beta-Thalassemia Major Patients
title_full Correlation of Serum Ferritin and Cardiac Iron Toxicity with Cardiac Function in Transfusion Dependent Beta-Thalassemia Major Patients
title_fullStr Correlation of Serum Ferritin and Cardiac Iron Toxicity with Cardiac Function in Transfusion Dependent Beta-Thalassemia Major Patients
title_full_unstemmed Correlation of Serum Ferritin and Cardiac Iron Toxicity with Cardiac Function in Transfusion Dependent Beta-Thalassemia Major Patients
title_short Correlation of Serum Ferritin and Cardiac Iron Toxicity with Cardiac Function in Transfusion Dependent Beta-Thalassemia Major Patients
title_sort correlation of serum ferritin and cardiac iron toxicity with cardiac function in transfusion dependent beta thalassemia major patients
topic cardiac iron toxicity
serum ferritin
systolic function
diastolic function
cardiac MRI T2*
url http://www.actamedindones.org/index.php/ijim/article/view/1782
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