Evaluation of electrocardiographic markers of cardiac arrhythmic events and their correlation with cardiac iron overload in patients with beta-thalassemia major

Demircan T., Onder Sivis Z., Tatli Gunes B., KARADENİZ C.

CARDIOLOGY IN THE YOUNG, no.11, pp.1666-1671, 2020 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Publication Date: 2020
  • Doi Number: 10.1017/s1047951120002498
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, Agricultural & Environmental Science Database, CINAHL, EMBASE, MEDLINE
  • Page Numbers: pp.1666-1671
  • Keywords: Thalassemia, iron overload, red blood cells, electrocardiography, MAGNETIC-RESONANCE, QT DISPERSION, INTERVAL, HEART, DIAGNOSIS, INDEX
  • Dokuz Eylül University Affiliated: No


Iron overload is associated with an increased risk of atrial and ventricular arrhythmias. Data regarding the relationship between electrocardiographic parameters of atrial depolarisation and ventricular repolarisation with cardiac T2* MRI are scarce. Therefore, we aimed to investigate these electrocardiographic parameters and their relationship with cardiac T2* value in patients with beta-thalassemia major. In this prospective study, 52 patients with beta-thalassemia major and 52 age- and gender-matched healthy patients were included. Electrocardiographic measurements of QT, T peak to end interval, and P wave intervals were performed by one cardiologist who was blind to patients' data. All patients underwent MRI for cardiac T2* evaluation. Cardiac T2* scores less than 20 ms were considered as iron overload. P wave dispersion, QTc interval, and the dispersions of QT and QTc were significantly prolonged in beta-thalassemia major patients compared to controls. Interestingly, we found prolonged P waves, QT and T peak to end dispersions, T peak to end intervals, and increased T peak to end/QT ratios in patients with T2* greater than 20 ms. No significant correlation was observed between electrocardiographic parameters and cardiac T2* values and plasma ferritin levels. In conclusion, our study demonstrated that atrial depolarisation and ventricular repolarisation parameters are affected in beta-thalassemia major patients and that these parameters are not correlated with cardiac iron load.