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Article Type

Original Study

Abstract

Objectives The aim of this study was to investigate the diagnostic and predictive value of plasma brain natriuretic peptide (BNP) levels in detecting diastolic dysfunction in β-thalassemic patients in comparison with conventional and new Doppler echocardiography indices. Background β-Thalassemia major is a unique disease characterized by early diastolic dysfunction related exclusively to iron myocardial deposition. BNP is a sensitive biomarker for the detection of asymptomatic left ventricular (LV) dysfunction and has important diagnostic and prognostic implications. Materials and methods This study enrolled 25 b-thalassemic major patients with normal systolic function and 10 age-matched and sex-matched individuals. All participants were studied thoroughly by tissue Doppler echocardiography and blood samples were taken for determination of BNP, ferritin, total iron, and complete blood count. Patients were divided into two groups according to the E mitral/E mitral annulus ratio (E/E«SQ») at cutoff point 8. Results BNP levels were higher in thalassemic patients compared with the control group. BNP and serum ferritin levels showed a statistically significant increase in group I (E/E«SQ» >8) in comparison with group II (E/E«SQ» <8). There was a statistically significant positive correlation between BNP and serum ferritin. Using receiver operating characteristic analysis, BNP at a cut point of 28.5 pg/ml was highly accurate (area under curve = 0.86, P = 0.003) in ruling out diastolic dysfunction (E/E«SQ» <8), with a sensitivity 88.9% and a specificity of 81.2%. Conclusion BNP level is significantly increased in LV diastolic dysfunction and has a predictive value in detecting latent LV diastolic dysfunction in β-thalassemia major.

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