Brain Natriuretic Peptides and Calcitonin Gene-Related Peptide in Diagnosis of Cardiac Involvement in Major Thalassemia Patients

Background: Cardiac dysfunction is one of the major causes of morbidity and mortality in thalassemia patients. This study aimed to compare the effect of Brain Natriuretic Peptides (BNP) and Calcitonin Gene-Related Peptide (CGRP) with echocardiographic findings in early diagnosis of cardiac disease in major thalassemia patients. Materials and Methods: This study was performed on 80 patients among 500 major thalassemia patients and 80 healthy people. Those with metabolic, endocrine disorder, hypertension, heart failure, and valvular disease excluded from the study. These two groups were matched based on age and sex. Essential heart findings were analyzed using Mylab 60. After blood sampling, levels of CGRP and BNP were measured by use of ELISA kit from extracted plasma. Mann-Whitney test, independent t-test, and Pearson correlation were used to analyze data and P< 0.05 was considered significant. Results: The results showed that mean age of all participants was 17.581&plusmn;5.344 years when distributed between case and control as 18.21 &plusmn;5.14 and 16.95 &plusmn;5.49 respectively without significant difference. Means of weight, length, hemoglobin, systolic and diastolic pressure were lower in patients group. The majority of echocardiography findings of left and right heart were higher in case group. The average of CGRP and BNP level were more in case group (p<0.05). A positive correlation was observed between BNP (R=0.229, P=0.041) and right MPI. There was also correlation between PEP(R=0.0238,P=0.035) , PEP/ET(P=0.005) of right heart and peak A velocity of left heart (R=0.245,P=0.03) with CGRP. Conclusion: Findings of this survey showed that systolic and diastolic function of left heart would be changed in patients with major beta thalassemia. Therefore, monitoring BNP and CGRP in symptom free thalassemia patients as well as serial echocardiography is recommended.