Role of Heart Fatty Acid Binding Protein in Myocardial Dysfunction in Children with β -Thalassemia Major

Background: Beta-thalassemia major (β-TM) is a hereditary hemoglobinopathy condition. For cases with beta thalassemia major, cardiac complications are a significant source of morbidity and death. Cardiac biomarkers showed valuable diagnostic and prognostic role in assessment of cardiac function.  Objective: This research aimed to assess the role of heart fatty acid binding protein in assessment and confirmation of myocardial dysfunction in kids with β-thalassemia major. Methods: This is an observational research that has been performed on 77 kids with β-thalassemia major complicated by asymptomatic LV myocardial dysfunction diagnosed by conventional echo. The kids attended the pediatric Department, Menoufia University Hospital (group 1), and 77 healthy matched kids as a control (group II).
Results: children with beta thalassemia major with myocardial dysfunction had significantly higher heart fatty acid binding protein (HFABP) levels than healthy-matched children. HFABP might be utilized as a good instrument for identification of early myocardial dysfunction in kids with β-TM with an area under the curve of 0.842 (p-value equal to 0.001) at ninety-five percent CI of (0.774-.911). HFABP can be used to diagnose myocardial dysfunction at cut-off value >1.98 pg/mL with 91.34% sensitivity and 63.12 % specificity.
Conclusion: H-FABP has proven to be a valuable biomarker for early recognition of myocardial dysfunction in kids with β-TM, even in the absence of clinical symptoms. Elevated H-FABP levels correlate with subclinical myocardial injury and iron overload, making it a promising tool for early intervention.