Tumor Necrosis Factor alpha, N-terminal Pro Brain Natriuretic Peptide and Interleukin-6 Correlations with Doppler Tissue Imaging findings in Major Thalassemia Patients

  Background   In respect to abnormalities in thalassemia patients and the effects of TNF_α, IL_6, and NT-pro-BNP on echocardiography findings the study aimed to investigate TNF_α, NT-pro-BNP and IL_6 correlations with Doppler tissue imaging findings in major thalassemia.   Materials and Methods:  This case-control study was performed on 112 healthy children and 112 patients with thalassemia in Ali Asghar hospital, Zahedan, Iran, in 2017. Healthy children were selected from those that referred to the pediatric clinics for routine check-up. Fasting blood samples were taken to measure TNF-α, NT-pro-BNP and IL_6 serums. Those thalassemia patients who had regular transfusions of hemoglobin higher than 10 g/dl and 48-72 h after packed red blood cell transfusion and those who were asymptomatic were entered to the study. Participants underwent echocardiography by pediatric cardiologist in Doppler method.   Results: NT-pro-BNP, TNF_α and IL_6 were lower in controls (P<0.001). Height, weight and BMI were higher in controls (P<0.001). Right ET, left ET, IVSD, PWD, PWS, EF, FS, left ET', left ICT', left IRT', right ET', right IRT', right S', right Peak A', VE', VA', left and right MPI', LVMI were different in case and control (P<0.05). Right Peak A (P=0.049), PWD (P=0.032), Left MPI' (P=0.02) and LVMI (P=0.005) were correlated with IL_6. IVSD (P=0.01), LVDS (P=0.01), EF and FS (P<0.001), left ET' (P=0.02), left ICT' (P<0.001), right ET' (P=0.001), right S' (P=0.002), left MPI’ (P<0.010) were correlated with NT-pro-BNP.   Conclusion   NT-pro-BNP, TNF_α, IL_6 were higher in thalassemia patients and NT- pro-BNP was correlated with some of the echocardiography findings. This suggests that NT-pro-BNP would be the best biomarker for evaluation of cardiac functions in thalassemia patients.