الفهرس 
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Abstract
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Summary
Beta thalassemia major is a chronic hemolytic anemia because of abnormal hemoglobin synthesis. These patients are at risk for iron overload and tissue intoxication. Heart failure is the most common and the leading cause of mortality in these patients. Heart complications could be prevented or attenuated with frequent transfusions and deferoxamine administration as a specific iron chelator .
Cardiac complications such as heart failure and arrhythmias, caused by the so called “iron induced” cardiomyopathy, are considered to be the primary cause of death in patients with β thalassaemia major .
The aim of this study was to diagnose cardiac affection in beta thalassemia major patients on frequent blood transfusion, assess this function by echocardiography and measurement of serum troponin I and to find a relationdhip with serum ferritin level.
This study was conducted on 35 children ranging in age between (10-18) years old.Tweenty patients (group 1) with beta-thalassemia major, randomly selected as diseased group from those cases attending to pediatric hematology clinic ,Banha faculty of medicine and el obour hospital, Kafr EL-Sheikh.
Fifteen healthy children (group 2) with the same age group were taken as control group in the period from August 2013 to April 2014.
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These 2 groups were subjected to:
A-Laboratory:
For the studied group all the following was done:
Complete blood picture, serum ferritin and serum troponin I.
B-Echocardiography:
The patients were examined in the post transfusion state by two to three days in the echocardiographic unit at pediatric department at Banha faculty of medicine.
Ths study was done on 20 thalassemic children 10-18 years old and 15 healthy children age & sex matched .
The patients were subjected to history taking, clinical examination, CBC, Hb, S. ferritin, s.troponin I and echocradiagraphy examination, through measuring LVEDD, LVESD, EF, FS, PAP and transmitral Doppler flow of E &A waves.
Tweenty β-thalassemia patients ( Group1) were included in this study (9 males and 11 females), their age ranging from 10-18 years with a mean of 12.3±2.3 years . In addition to 15 healthy children with the same age group as group 2 with a mean of 12.0±1.9 years.
The range of Hb for cases was 5.5-7.1 with a mean of 6.3±0.5, 4.4±3.9.The range of s. ferritin in cases was 840-5300 with a mean of 2023.7±1428.7, while the range of s. troponin I was 0.006-009 with a mean of 0.01±0.02 in cases of thalassemia.
There was high significant relation in height, head circumference, weight and family history between group1 and group 2 . E/A ratio was
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inverted in 25% of cases. There was high significant negative correlation between serum troponin I and E/A ratio.
There was significant positive correlation between serum troponin I and the following variables (Systolic PAP ,serum ferritin and LVESED) in group 1.
There was no significant correlation between serum troponin I and EF.
There was significant correlation between s. ferritin and the following variables (Systolic PAP, ,TR,MR,LVEDD and LVESED) in group 1, while there was significant negative correlation between s. ferritin and EF and significant high negative correlation with E/A ratio in the same group.
There was no significant correlation between serum troponin I and EF.