Kadir ACAR, Orhan ÖZBEK, Enes Elvin GÜL, Turyan ABDULHALİKOV, Ramazan UÇAR, Mehmet KAYRAK

Cardiac iron load and novel p-wave measurements in patients with thalassemia major The role of P index and Interatrial Block

Kalpteki demir yükünün ventriküler repolarizasyon üzerindeki olumsuz etkileri beta-talasemi hastalarında gösterilmiştir. Fakat atriyal fibrilasyon (AF) gelişiminin bağımsız risk faktörleri olan P-dalga parametreleri ile ilgili beta talasemili hastalarda kısıtlı bilgi vardır. Bu nedenle biz asemptomatik beta talasemili hastalarda P-dalga parametreleri ile magnetic rezonans görüntülemede (MRG) elde edilen demir yükü arasındaki ilişkiyi araştırmayı amaçladık.Çalışmaya 22 β-TM hastaları ve yaş ve cinsiyetle uyumlu olan 22 sağlıklı kontrol dahil edildi. P max, P min, and Pi β-TM grupta sağlıklı kontrole gore anlamlı derecede yüksek tespit edildi (p=0.005, p=0.01, and p=0.03, sırasıyla). Pd gruplar arasında benzer bulundu (p=0.46). Kısmı IAB prevalansı β-TM hastalarında artmış bulundu ve komplet IAB sadece bir hastada görüldü P-dalga parametreleri kardiyak T2*=20 msan olan hastalarda benzer bulundu. P-dalga parametreleri ile kardiyak T2* MRG değerleri arasında anlamlı korelasyon izlenmedi. Bu çalışma gösterdi ki, P-dalga parametreleri sol ventrikül fonksiyonları korunmuş olan β-TM hastalarında kısmen etkilenmiştir ve bu bozulma kardiyak demir yükü ile ilişkili değildir. Sonuç olarak, β-TMnin AF gelişmesindeki rolü halen tartışmalıdır.

Kalpteki demir yükü ve talesemi majör hastalarında yeni p-dalga ölçümleri

The deleterious effects of cardiac iron load on the ventricular repolarization were demonstrated in beta-thalassemia major (β- TM), but little is known about the P wave measurements, an independent risk factor for development of atrial fibrillation (AF). We aimed to examine relationship between P-wave parameters and iron loading using cardiac T2* Magnetic Resonance Imaging (MRI) in asymptomatic β-TM patients. The study involved 22 β-TM patients and 22 age- and gender-matched healthy controls. Although P-wave parameters were within normal limits, P max, P min, and Pi were significantly prolonged in the β-TM group compared to the healthy controls (p=0.005, p=0.01, and p=0.03, respectively). Pd was found similar between groups (p=0.46). The prevalence of partial IAB was increased in patients with β-TM (p=0.001) and complete IAB was detected only in one patient. P-wave param- eters of patients with cardiac T2*=20 msec were comparable in patients with β-TM. There was no correlation between P-wave parameters and cardiac T2*MRI values. The present study demonstrated that P-wave measurements were slightly affected in β-TM patients with preserved LV functions and this influence was not related with cardiac T2*MRI values. We concluded that the effect of β-TM on the AF development is still controversial.

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