Serum ferritin levels correlation with heart and liver MRI and LIC in patients with transfusion-dependent thalassemia

Abstract

Background: Iron-loaded cardiac complication is the essential cause of mortality in patients with thalassemia. Early detection and treatment of cardiac over-load can reduce mortality. Objectives: The current study aimed to evaluate the relationship between serum ferritin levels and T2 * magnetic resonance imaging (MRI) of heart and liver and liver iron concentration (LIC) to diagnose iron over load in countries with limited access. Patients and Methods: In the current cross-sectional study, 85 Iranian patients with thalassemia with the mean age of 22.7 ± 7 years were randomly selected. All patients were on regular blood transfusion. Echocardiography of heart and liver T2 * MRI, determination of serum ferritin levels, and LIC were performed in all subjects at the same time. The correlation of serum ferritin levels with T2 * MRI of heart and liver, and LIC was assessed. P value < 0.05 was considered statistically significant. Results: Abnormal myocardial iron load (T2 * MRI < 20 ms) was detected in 58% of the patients and among whom, 36% had severe myocardial iron load (T2 * MRI < 10 ms). Median and interquartile range of serum ferritin levels were 1434 and 2702 respectively in patients with thalassemia. Serum ferritin levels showed a statistically significant positive correlation with LIC (r s = 0.718, P < 0.001) and significant negative correlation with T2 * Heart (r s = -0.329, P = 0.002), and T2 * Liver (r s = -0.698, P < 0.001). However, Ejection fraction was not significantly correlated with serum ferritin levels in the patients (P = 0.399). Conclusions: Serum ferritin levels can be used to diagnose iron over-load in patients with thalassemiaas an alternative method in areas where T2 * MRI is not available.