Atrial Function and Glutathione in Children with Iron Deficiency Anemia- Tanta-Egypt-2012

Abstract

Aims: is to correlate the atrial function with the level of oxidative stress marker (Glutathione) in children with Iron deficiency anemia (IDA). Materials and Methods: Thirty children with IDA and 20 healthy children had serum Ferritin, total blood Glutathione level and studied with conventional trans-thoracic 2-D echocardiography, Tissue Doppler (TDI) and Speckle Tracking Strain (STI) analysis. Study Design:  A case–controlled study Place and Duration of Study: Pediatric Outpatient Clinic; Pediatric Hematology Unit; Pediatric Cardiology Unit; Pediatric Department; Faculty of Medicine; Tanta University Hospital; Egypt. The study was conducted between January; 2012 to December; 2012. Results: Children with IDA had significantly low Glutathione [4.63 ±3.4 ng/ml] (P =.013) and Ferritin [11.88 ±5.3 ng/ml] (P < .0001) levels than that observed in the control group. There was no significant increase in LA dimension and volume (minimum) [31± 27 ml] (P = .433), by M-mode but there was significant decrease in e/a ratio assessed by tissue Doppler in IDA patients [1.29 ±0.5] than in controls [1.6±0.7] (P = .038). There were significant decrease in LA velocity (P = .02) and increase in RA velocity (P = .04) compared to left atrial and atrial septal velocity and insignificant increase in left atrial velocity compared to atrial septal velocity. There was no significant correlation between Glutathione level and echo-Doppler parameters of atrial function (P >.05), but there was significant negative correlation between Hemoglobin% and atrial septal velocity (P < .05). Conclusion: IDA is associated with diastolic dysfunction. Tissue Doppler and STI were more sensitive than conventional echocardiography in detection of subclinical structural and functional changes due to hemodynamic abnormality in children with IDA.