MECNUN ÇETİN, Nichal MOUMIN, Bertan KARABOĞA, ŞENOL COŞKUN, HÜSEYİN GÜLEN

Evaluation of cardiac autonomic functions in Children with Thalassemia Trait, Iron Deficiency Anemia and Iron Deficiency

Distruption of cardiac autonomic functions during diseases associated with anemia were reported in multiple studies previously. Objective in this study is to investigate heart rate variability (HRV) for evaluation of cardiac autonomic functions in children patients with Thalassemia trait (TT), iron deficiency anemia (IDA) and iron deficiency (ID) without anemia. Twenty-five patients with TT, 25 patients with IDA, 25 patients with ID, and 25 healthy controls were assessed with 24hour ambulatory electrocardiography recordings. The following time-domain indices were calculated; standard deviation values of all normal sinus R-R intervals for 24 hours (SDNN), standard deviation levels of all mean normal sinus R -R interspaces over each 5-minute strip in the 24-hour enrollments (SDANN), the square root of the mean of the sum of squares of differences between adjacent RR intervals (RMSSD), percentage of difference between adjacent normal R -R intervals that are greater than 50 ms computed for the overall 24-hour ECG recording (pNN50). Re-evaluation regarding HRV were done in children with IDA after 4 months of treatment. Although reduction in HRV parameters was detected in IDA group compared to ID, TT, and control groups, it wa s statistically not significant. The pNN50 was significantly low only in the IDA group (p=0.042). When ID group and TT group were compared with control group, it was found that HRV parameters were not affected. In IDA group, SDNN, SDANN, RMSSD and pNN50 index were significantly higher after trea tment (p=0.002, p=0.005, p=0.005, p=0.010, respectively). Our results indicate that cardiac autonomic activity are affected in IDA and improvement occurs after treatment. HRV parameters were found to be especially associated with hemoglobin and hematocrit values.

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