Heart rate variability in children with iron deficiency anemia and talasemia trait

Aim: Iron deficiency anemia is the most common hematologic disease of childhood.Anemia can result in cardiologic manifestations like tachycardia, tachypnea, cardiomegalyand systolic murmur. Distruption of cardiac autonomic functions during diseasesassociated with anemia (Vit B12 deficiency, sickle cell anemia, thalasemia major) werereported in multiple studies previously. But number of studies evaluating cardiacautonomic functions in patients with iron deficiency anemia are limited. In fact there areno studies conducted in thalasemia patients. The aim of this study was to determine heartrate variability for evaluation of cardiac autonomic functions in children with irondeficiency anemia and thalasemia trait.Method: 25 children (18 girls, 7 boys) with iron deficiency anemia, 25 children (19girls, 6 boys) with ıron deficiency but no anemia, 25 children (11 girls, 14 boys) withthalasemia trait and 25 children (13 girls, 12 boys ) as control group, of ages between 5-18 years were included in the study. 24 hour Holter ECG monitorization were performed inall participants and time-interval heart rate variability parameters (SDNN, SDANN,RMSSD, pNN50) were calculated. Re-evaluation regarding heart rate variability were donein children with iron deficiency anemia after 4 months of treatment.Results: Although reduction in heart rate variability parameters was detected in irondeficiency anemia group compared to control group, it was statistically not significant.When iron defiency group and thalasemia trait group were compared, we found that heartrate variability parameters were not affected. Evaluation of heart rate variability parametersbefore and after treatment in iron deficiency anemia group revealed statistically significantincrease in SDNN 24 h, SDANN, SDNN index, RMSSD ve pNN50 index (p<0,05). Meanheart rate was significantly higher before treatment (p=0,001).Conclusion: Our results indicate that cardiac autonomic activity are affected in irondeficieny anemia and improvement occurs after treatment. Heart rate variability parameterswere found to be especially associated with hemoglobin and hematocrit values.