The role of brain natriuretic peptide and tissue doppler echocardiography in the management of transfusion dependent thalassaemia patients

摘要: Background: Iron induced heart failure is the commonest cause of death in thalssaemia major. The cardiomyopathy reversible when treated early, but once symptomatic occurs, outlook poor. A recent technique using magnetic resonance myocardial T2* (T2 star) has been validated for assessment early iron deposition. Worldwide however, transthoracic echocardiography mainstay these patients. Conventional echo parameters are poor at identifying those with cardiac loading who risk failure, only becoming abnormal significant occurred. Newer techniques involving tissue Doppler imaging (TDI) have promising. Our aim was to explore role and that brain natriuretic peptide (BNP), a biomarker released management Thalassaemia major Methods/Results: 167 patients thalassaemia were screened MRI quantify loading. Those severe iron, <8ms, (n=15) both desferrioxamine deferiprone chelation. mild moderate 8- 20ms, (n=65) randomised plus either or placebo. Both groups 12 months. At baseline, 6 months all combination therapy trial group assessed T2*, full including TDI BNP levels. became obvious clinical failure. systolic velocities septum RV significantly lower improved over months, correlating an improvement T2*. Conclusion: In patients, unhelpful assessing status. Systolic can give indication as individuals status could help monitor their progress during chelation therapy.