To the Editor: Iron overload is a primary cause of morbidity and mortality among β-thalassemia major patients, with heart diseases being the predominant cause of death [
1]. Chronic anemia and transfusional iron overload impair cardiac function. This cross-sectional study evaluated the correlation between serum ferritin levels and cardiac function in 85 multi-transfused β-thalassemia major patients (3–18 y) using echocardiographic (ECHO) and electrocardiographic (ECG) assessments [
2]. Prolonged QT and corrected QT intervals were observed in 45.9% of patients, all with serum ferritin levels > 5000 ng/dl. Diastolic dysfunction was more prevalent than systolic dysfunction in ECHO findings, showing a significant positive correlation with serum ferritin levels. Conversely, systolic dysfunction (ejection fraction alteration) exhibited a strong negative correlation with serum ferritin levels. Our findings indicate that diastolic dysfunction on echocardiography is an early sign of myocardial dysfunction, while ECG abnormalities detect heart failure due to iron overload later in the disease course [
3]. Thus, echocardiography, coupled with serum ferritin levels, is crucial for early detection and monitoring of cardiac dysfunction in β-thalassemia major patients [
4]. Further research with a larger sample size and younger subjects is recommended to generalize these findings. This study underscores the importance of regular cardiac evaluation in thalassemia patients to mitigate iron overload-related complications. …
