IJMABHR International Journal of Medical and All Body Health ResearchIJMABHR 2582-8940 Anfo Publication House 486 10.54660/IJMBHR.2026.7.2.216-222 Cardiac Complications in Iraqi Children with Beta-Thalassemia Major: Association with Serum Ferritin and Chelation Adequacy EtaijDafer Mahammad Hussein BegKarrar Abdil Aziz Ali NasrawiAlaa Jumaah Manji Department of Pediatrics, College of Medicine, Jabir Ibn Hayyan University for Medical and Pharmaceutical Sciences, Najaf, Iraq Department of Pediatrics, College of Medicine, University of Kufa, Najaf, Iraq 22052026 7 2 216 222 26032026 24042026 CC BY-NC-SA 4.0

Background: Beta thalassemia major (BTM), an inherited hemoglobinopathy, is characterized by absent or severely reduced β-globin chain synthesis, resulting in transfusion-dependent anemia that begins early in life. Cardiac complications, primarily iron-overload cardiomyopathy and congestive heart failure, remain the most common cause of mortality in these patients despite several decades of advances in supportive care. Objective: To investigate the cardiac function in Iraqi children with BTM using ECG and Echocardiography, to determine whether abnormal findings of these tests are related to inadequate chelation therapy (assessed by urine drug levels) and body iron overload (estimated by serum ferritin), and to assess the correlation between CXR parameters versus echocardiographic measurements. Methods: A cross-sectional study of 49 patients with beta-thalassemia major (BTM) disorder followed up at the outpatient clinic of AL-Zahraa Teaching Hospital, Al-Najaf, Iraq, from June to November 2025, comprising 29 males and 20 females aged between 10 months and 17 years.) ECG, transthoracic echocardiography, and CXR were performed in all the patients. We defined chelation adequacy as deferoxamine use≥ 4 days/week (optimal) or

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