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Introduction -thalassemia is the most common inherited disease, characterized by decreased or absent -globin chain synthesis and hemoglobin A production ( The incidence of myocardial iron overload in transfusion-dependent -thalassemia patients has increased from 11.4%15.1% in early studies to 26.1%36.7% in recent studies ( As iron loading progresses, the capacity of transferrin to bind and detoxify iron is eventually exceeded, leading to non-transferrin-bound iron in plasma, which promotes oxidative stress, mitochondrial dysfunction, and ferroptosis ( Mechanisms of myocardial injury caused by iron overload Studies have shown that iron myocardial overload causes myocardial dysfunction

34 SeilerA.SchneiderM.FrsterH.RothS.WirthE

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PMID: 36457729

Without adequate bioavailable copper, newly formed collagen fibers remain structurally weak and prone to degradation