Assessment Of Tp-E Interval, Tp-E/Qt, Tp-E/Qtc Ratıos In Thalassemıa Major Patıents

Abstract

Aim: Thalassemia major (TM) is a genetic hemoglobinopathy that causes chronic hemolytic anemia. Repeated blood transfusions are needed for treatment. Iron accumulation is used to predict the risk of ventricular arrhythmia. We designed this study to compare the Tp-e interval, Tp-e/QT ratio and Tp-e/QTc ratio, which are the novel and reliable predictors that show ventricular repolarization, between the TM patients and healthy control group. Method: We included 97 TM patients who presented to our outpatient clinic for routine cardiac check-up from March 2019 to June 2020 and 90 healthy volunteers. In addition to the demographic and echocardiographic findings, patients’ electrocardiograms (ECG) were retrospectively analyzed. Their serum ferritin, C reactive protein (CRP) levels and neutrophil to lymphocyte ratios were recorded and compared. Result: The Tp-e interval was 80 msn (60.0-80.0) in the group of thalassemia major patients whereas it was 60 msn (50.0-70.0) (p<0.001) in the control group. The Tp-e/ QT ratio was 0.200 (0.160-0.225) in the TM group while it was 0.175(0.150-0.210) in the control group (p=0.014). The Tp-e/QTc ratio was 0.180 (0.130-0.190) in the TM group while it was 0.150 (0.130-0.180) in the control group (p=0.035). No correlation was found between their serum ferritin levels and ECG parameters. Conclusion: Prolonged Tp-e interval, Tp-e/QT ve Tp-e/QTc ratios on the ECG in TM patients are associated with impaired ventricular repolarization due to excessive cardiac iron deposition and ventricular arrhythmias. These simple but reliable parameters can be used to predict the risk of arrhythmia