Evaluation of the Relationship Among Pulmonary Artery Pressure with Serum Ferritin Level and CMR T2* in Thalassemia Major

Fatemeh Ostad-Hosini; Mohammad Reza Safaei Qomi; Aziz Eghbali; Vahid Falahati; Sarvenaz Mehrabi; Yazdan Ghandi

doi:10.12865/CHSJ.47.02.06

Evaluation of the Relationship Among Pulmonary Artery Pressure with Serum Ferritin Level and CMR T2* in Thalassemia Major

Curr Health Sci J. 2021 Apr-Jun;47(2):184-189. doi: 10.12865/CHSJ.47.02.06. Epub 2021 Jun 30.

Authors

Fatemeh Ostad-Hosini¹, Mohammad Reza Safaei Qomi¹, Aziz Eghbali², Vahid Falahati³, Sarvenaz Mehrabi¹, Yazdan Ghandi³

Affiliations

¹ School of Medicine, Arak University of Medical Sciences, Arak, Iran.
² Pediatric Oncology, Iran University of Medical Sciences, Tehran, Iran.
³ Pediatric Oncology, Amir-Kabir Hospital, Arak University of Medical Sciences, Arak, Iran.

Abstract

Background: Pulmonary hypertension is one of the most common cardiac complications among patients with β-thalassemia major (β-TM). The aim of this study is to investigate the correlation of pulmonary artery pressure (PAP), serum ferritin level, and cardiac T2* MRI in patients with β-TM.

Method: This cross-sectional study was performed on 50 patients older than 7 years old. Echocardiography, electrocardiography, and cardiac T2* MRI were performed on all patients and their serum ferritin levels were measured. Based on the echocardiographic the patients were divided into two groups of PAP>30 and <30 mmHg.

Results: 40% had PAP higher than 30 mmHg, 32% had abnormal T2* MRI, and 36% had serum ferritin levels higher than 1500ng/dl. there were significant negative correlations between CMRI *T2 and PAP (-0.36) and the P-pulmonary (-0.29). the serum ferritin level was positively correlated with PAP (0.44) and the P pulmonary in ECG (0.30). in the patients with PAP>30, the means of age, serum ferritin level, and P-pulmonary were significantly higher than patients with PAP<30 (P=0.001). In the patients with PAP>30mmHg, CMRI *T2 had higher accuracy (80%), sensitivity (65%), and specificity (90%) compared to the measurement of serum ferritin levels.

Conclusion: The PAP was positively correlated with serum ferritin levels and negatively with T2MRI. The accuracy of 80% for T2MRI as a method to diagnose or even anticipate PH among patients with TM suggested that this method is a useful and accurate method of PH diagnosis and can be used as an alternative among clinicians.

Keywords: Cardiac T2* MRI; Pulmonary Artery Pressure; Serum Ferritin Levels; β-Thalassemia Major.