ABSTRACT
Aim:This study aimed atassessingP-wave and QT interval dispersion in children with β-thalassemia and to correlate them with various laboratory and echocardiographic data. Methodology:Subjects comprised of 30 children with β-thalassemia major as the patient group. 30 healthy children matched for age and sex served as the control group. All patients were evaluated clinically as well as by echocardiography and 12 leads ECG. The type of study isprospective case control study.Results:There was a statistically significant increase ofInterventricular Septal end diastole(IVSd),Interventricular Septal end systole(IVSs),Left Ventricular Internal Diameter end diastole (LVIDd), Left Ventricular Internal Diameter end systole(LVIDs) andLeft Ventricular Posterior Wall end diastole(LVPWd) in patients as compared to controls (Mean ±SD = 0.950±0.166, 0.863±0.103, 3.983±0.456, 2.947±0.535and 0.797±0.165 respectively) (P < 0.05). Moreover, there were a significant increase of LV mass (Mean ±SD = 107.267±26.736, P= 0.002) and LV mass index of the studied patients (Mean ±SD = 106.900±22.651, P = 0.005)compared to the controls. There were significant decrease ofejection fraction(EF%)(Mean ±SD = 60.373 ± 8.088, P = 0.032)and fractional shortening(FS%) (Mean ±SD = 29.495 ± 4.171, P = 0.026) of the studied patients compared to control group. Both P wave dispersion (PWd) (Mean ±SD = 33.667 ± 13.767, P = 0.029) and QT dispersion (QTd) (Mean ±SD = 53.000 ± 18.411, P = 0.001) were significantly higher in patients compared to controls. There was a significant positive correlation between PWd and serum ferritin(r =0.551,P-value=0.002), LVIDd (r =0.406,P-value=0.026), LVPWd(r =0.461,P-value=0.010), LV mass (r =0.412,P-value=0.024), and LV mass index(r = 0.379,P-value=0.039). While, there were a significant positive correlations between QTd and serum ferritin (r =0.654,P-value <0.001), LVIDd (r = 0.388,P-value =0.034), LV mass (r = 0.454,P-value =0.012)and LV mass index (r = 0.456,P-value =0.011). Conclusion:P wave dispersion and QT dispersion were prolonged in children with β-thalassemia major denoting cardiac autonomic dysfunction with homogeneity disorders of atrial conduction and ventricular repolarization in these patients
ABSTRACT
Aims: is to correlate the atrial function with the level of oxidative stress marker (Glutathione) in children with Iron deficiency anemia (IDA). Materials and Methods: Thirty children with IDA and 20 healthy children had serum Ferritin, total blood Glutathione level and studied with conventional trans-thoracic 2-D echocardiography, Tissue Doppler (TDI) and Speckle Tracking Strain (STI) analysis. Study Design: A case–controlled study Place and Duration of Study: Pediatric Outpatient Clinic; Pediatric Hematology Unit; Pediatric Cardiology Unit; Pediatric Department; Faculty of Medicine; Tanta University Hospital; Egypt. The study was conducted between January; 2012 to December; 2012. Results: Children with IDA had significantly low Glutathione [4.63 ±3.4 ng/ml] (P =.013) and Ferritin [11.88 ±5.3 ng/ml] (P < .0001) levels than that observed in the control group. There was no significant increase in LA dimension and volume (minimum) [31± 27 ml] (P = .433), by M-mode but there was significant decrease in e/a ratio assessed by tissue Doppler in IDA patients [1.29 ±0.5] than in controls [1.6±0.7] (P = .038). There were significant decrease in LA velocity (P = .02) and increase in RA velocity (P = .04) compared to left atrial and atrial septal velocity and insignificant increase in left atrial velocity compared to atrial septal velocity. There was no significant correlation between Glutathione level and echo-Doppler parameters of atrial function (P >.05), but there was significant negative correlation between Hemoglobin% and atrial septal velocity (P < .05). Conclusion: IDA is associated with diastolic dysfunction. Tissue Doppler and STI were more sensitive than conventional echocardiography in detection of subclinical structural and functional changes due to hemodynamic abnormality in children with IDA.