Increased sympathovagal imbalance evaluated by heart rate variability is associated with decreased T2* MRI and left ventricular function in transfusion-dependent thalassemia patients

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Pattanakuhar, Sintip and Phrommintikul, Arintaya and Tantiworawit, Adisak and Konginn, Sasikarn and Srichairattanakool, Somdet and Chattipakorn, Siriporn C. and Chattipakorn, Nipon (2018) Increased sympathovagal imbalance evaluated by heart rate variability is associated with decreased T2* MRI and left ventricular function in transfusion-dependent thalassemia patients. Bioscience Reports, 38 (1). BSR20171266. ISSN 1573-4935 (https://doi.org/10.1042/BSR20171266)

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Abstract

Early detection of iron overload cardiomyopathy is an important strategy for decreasing 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. HRV, evaluated by 24-h Holter monitoring, non-transferrin bound iron (NTBI), serum ferritin, left ventricular (LV) ejection fraction (LVEF), and CMR-T2* were determined. Patients with a cardiac iron overload condition had a significantly higher low frequency/high frequency (LF/HF) ratio than patients without a cardiac iron overload condition. Log-serum ferritin (r = −0.41, P=0.008), serum NTBI (r = −0.313, P=0.029), and LF/HF ratio (r = −0.286, P=0.043) showed a significant correlation with CMR-T2*, however only the LF/HF ratio was significantly correlated with LVEF (r = −0.264, P=0.043). These significant correlations between HRV and CMR-T2* and LVEF in TDT confirmed the beneficial role of HRV as a potential early screening tool of cardiac iron overload in thalassemia patients, especially in a medical center in which CMR T2* is not available. A larger number of TDT patients with cardiac iron overload are needed to confirm this finding.

ORCID iDs

Pattanakuhar, Sintip ORCID logoORCID: https://orcid.org/0000-0003-2568-5897, Phrommintikul, Arintaya, Tantiworawit, Adisak, Konginn, Sasikarn, Srichairattanakool, Somdet, Chattipakorn, Siriporn C. and Chattipakorn, Nipon;
CORE (COnnecting REpositories)