Abstract
Cardiac dysfunction, including congestive heart failure and fatal arrhythmia, is a frequent cause of death among children with thalassemia major (TM). Autonomic nervous system activity typically is measured by a series of cardiovascular autonomic function tests, but these tests are unsuitable for young patients because they are invasive or complex. Heart rate variability assessment is a technique that measures the beat-to-beat variability in R-R intervals. This variability reflects changes in autonomic activity and their impact on cardiovascular function. This study examined 32 patients with TM to evaluate heart rate variability (HRV) in a preclinical phase of cardiac involvement. The study patients showed no evidence of heart failure or signs of peripheral or autonomic neuropathy. All HRV parameters were significantly reduced in the TM patient group compared with the control group. The results of this study can be interpreted as evidence of early cardiac autonomic neuropathy in young thalassemic patients. Therefore, all TM patients should be screened using HRV analysis for that complication.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Anderson L, Holden S, Davis B et al (2001) Cardiovascular T2-star (T2*) magnetic resonance for the early diagnosis of myocardial iron overload. Eur Heart J 22:2171–2179
De Chiara B, Crivellaro W, Sara R et al (2005) Early detection of cardiac dysfunction in thalassemic patients by radionuclide angiography and heart rate variability analysis. Eur J Haematol 74:517–522
Franzoni F, Galetta F, Di Muro C et al (2004) Heart rate variability and ventricular late potentials in beta-thalassemia major. Haematologica 89:233–234
Gurses D, Ulger Z, Levent E et al (2005) Time domain heart rate variability analysis in patients with thalassaemia major. Acta Cardiol 60:477–481
Kremastinos DT, Tsiapras DP, Tsetsos GA et al (1993) Left ventricular diastolic Doppler characteristics in beta-thalassemia major. Circulation 88:1127–1135
Nathan DG, Orkin SH (1998) The thalassemias. In: Nathan and Oski’s hematology of infancy and childhood, vol 1, 5th edn. WB Saunders Company, Philadelphia, pp 811–886
Sahn DJ, De Maria A, Kisslo J, Weyman A (1978) The committee on M-mode standardization of the American Society of Echocardiography: results of a survey of echocardiographic measurements. Circulation 58:1072–1083
Spirito P, Lupi G, Melevendi C, Vecchio C (1990) Restrictive diastolic abnormalities identified by Doppler echocardiography in patients with thalassemia major. Circulation 82:88–94
Task force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology (1996) Heart rate variability standards of measurement, physiological interpretation, and clinical use. Circulation 93:1043–1065
Veglio F, Melchio R, Rabbia F et al (1998) Blood pressure and heart rate in young thalassemia major patients. Am J Hypertens 11:539–547
Zurlo MG, De Stefano P, Borgna-Pignatti C et al (1989) Survival and causes of death in thalassaemia major. Lancet 2:27–30
Acknowledgment
This study was supported by Akdeniz University Administration of Scientific Research Projects.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kardelen, F., Tezcan, G., Akcurin, G. et al. Heart Rate Variability in Patients with Thalassemia Major. Pediatr Cardiol 29, 935–939 (2008). https://doi.org/10.1007/s00246-008-9240-1
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00246-008-9240-1