Author + information
- Sintip Pattanakuhar,
- Arintaya Phrommintikul,
- Adisak Tantiworawit,
- Sasikarn Konginn,
- Somdej Srichairattanakool,
- Siriporn Chattipakorn and
- Nipon Chattipakorn
Background: Early detection of iron overload cardiomyopathy is an important strategy to decrease the mortality rate of patients with transfusion dependent thalassemia (TDT). Although cardiac magnetic resonance (CMR) T2* is effective in detecting cardiac iron deposition, it is costly and not generally available. We investigated whether heart rate variability (HRV) can be used as a screening method of iron overload cardiomyopathy in TDT patients.
Methods: TDT patients (n = 69, mean age = 28 ± 9 years, 40% male) were enrolled. 24-hour Holter monitoring was recorded in all patients. HRV, non-transferrin bound iron (NTBI), serum ferritin, left ventricular (LV) ejection fraction (LVEF), and CMR-T2* were determined.
Results: The prevalence of cardiac iron overload (CMR-T2* ≤ 20 ms) was 0.87 per 1,000 cases. Mean rate of transfusion times during the last 12 months was 1.5 ± 0.5. Patients with cardiac iron overload condition had higher LF/HF ratio (i.e. frequency domain parameter of HRV) than patients without iron overload condition (1.78 ± 0.3 vs 1.48 ± 3.2, p = 0.035). Serum ferritin (r = -0.338, p = 0.008), serum NTBI (r = -0.313, p = 0.027) and LF/HF ratio (r = -0.264, p = 0.043) were significantly correlated with CMR-T2*, however only LF/HF ratio was also significantly correlated with LVEF (r = -0.261, p = 0.034) (Figure).
Conclusions: The significant correlations between HRV and CMR-T2* and LVEF in TDT confirmed the beneficial role of HRV as a potential predictor of cardiac iron overload as well as LV dysfunction.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Emerging Developments in HFpEF and Arryhthmias
Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical
Presentation Number: 1250-284
- 2017 American College of Cardiology Foundation