assessment of the relationship between iron overload based on cardiac t2* mri and fragmented qrs in beta-thalassemia major patients

Background: cardiac involvement in beta-thalassemia major patients is an important cause of mortality. therefore, in these patients, timely diagnosis of cardiac disorder is essential. objectives: the present study aimed at determining the association between cardiac iron overload and fragmented qrs (fqrs). methods: this cross-sectional study was conducted on 40 βtm patients, aged 5 - 40 years. the presence of fqrs was evaluated in 12-lead surface electrocardiograms. cardiac t2* mri was performed to determine the iron overload. the patients were divided into four groups of chelation therapy. results: the mean age of patients was reported to be 22.50 ± 6.75 years. the groups showed no significant difference regarding gender, age, or left ventricular ejection fraction. the presence of fqrs was detected in 10 patients (25%), while t2* value was lower than 20 ms in 10 patients (25%). the mean age of patients with and without fqrs was 26.23 ± 2.71 and 19.40 ± 2.61 years, respectively (p = 0.001). the univariate analysis indicated that fqrs had a significant relationship with cardiac iron overload (or = 5; 95% ci: 1.04 23.99; p < 0.044). the multiple logistic regression analysis represented a significant association between iron overload and fqrs (or = 5.556; 95% ci: 1.027 30.049). the sensitivity and specificity of the fqrs against mri were equal to 50% and 83.3% respectively. conclusions: the absence of fqrs on ecgs could be a good predictor of the lack of cardiac iron overload in βtm patients. the results showed that fqrs might indicate the no need for close monitoring for cardiac overload with cardiac mri and aggressive chelation therapy.