EFFECTS OF VITAMIN D SUPPLEMENTATION ON THE ELECTROCARDIOGRAPH RECORDS OF PATIENTS WITH BETA THALASSEMIA MAJOR: AN OPEN-LABEL RANDOMIZED CLINICAL TRIAL  

Raz M. HamaSalih a and Marwan S.M. Al-Nimer b



Department of Pharmacology and Toxicology, College of Pharmacy, University of Sulaimani, Kurdistan Region/ Iraq. 
b College of Pharmacy, Hawler Medical University, Erbil, Kurdistan Region/ Iraq. 


Submitted: 2/9/2019; Accepted: 18/2/2020; Published: 21/3/2020
ABSTRACT


Background 

Cardiac disease is believed to be the leading cause of death in thalassemia major. Iron cardiomyopathy is the primary cause of death in thalassemia major patients. Monitoring cardiac function with electrocardiography is essential in thalassemia major patients, however, diastolic and systolic dysfunction are later signs of iron overload. 


Objectives 

This study aimed to investigate the pleiotropic effect of vitamin D supplementation on the electrocardiograph records and cardiac risk variables in patients with beta thalassemia major.


Patients and Methods

Forty-six patients of beta thalassemia major were recruited in an open label, randomized clinical trial, from the Thalassemia Center of the General hospital in the Sulaimani city, Kurdistan Region. Oral dose of vitamin D of 100,000 IU ampoule was administered to the patients every two weeks for eight weeks as add on therapy. Electrocardiography (ECG), serum vitamin D levels, serum ferritin, body mass index (BMI), waist circumference and blood pressure were determined before (at baseline) and after eight weeks of vitamin D treatment. 


Results

Vitamin D3 supplements significantly prolonged PR period, QTcB interval, JTc interval and T-Pe duration in the electrocardiograph records. Additionally, a significant increase in body mass index and blood pressure were observed after supplementation with vitamin D. Furthermore, serum vitamin D was significantly increased and serum ferritin was significantly reduced after 8 weeks of supplementation with vitamin D.


Conclusions

Vitamin D supplement of 100,000 IU every two weeks causes risk when prescribed to patients with beta thalassemia major, since it impairs cardiac conduction.



KEYWORDS

Thalassemia, Vitamin D3, Electrocardiography.