Document Detail

Echocardiography in thalassemic patients on blood transfusions and chelation without heart failure.
MedLine Citation:
PMID:  23295250     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Patients with thalassemia major present chronic hemolysis and require regular blood transfusions which may cause iron overload cardiomyopathy and chronic heart failure. Hemochromatosis is characterized by excessive iron accumulation in tissues, and heart involvement is the main cause of death in patients with thalassemia.
OBJECTIVE: The aim of this study was to evaluate cardiac structure and function by conventional Doppler echocardiography and tissue Doppler imaging in patients with TM and no clinical evidence of heart failure.
METHODS: This is a prospective observational study including 18 patients with thalassemia major (TM) receiving regular blood transfusion. To separately evaluate anemia and blood transfusion effects, two gender, age, weight, and height-matched control groups were included: one with healthy individuals (Healthy, n=18) and one with iron deficient anemia patients (Anemia, n=18). Statistical analysis was performed using ANOVA followed by Tukey's test or Kruskal-Wallis's and Dunn's test.
RESULTS: The following echocardiographic variables presented significantly higher values in TM than the Anemia and Healthy groups: left atrium volume index (Healthy: 16.4±6.08; Anemia: 17.9±7.02; TM: 24.1±8.30 cm³/m²); mitral septal E/Em ratio (Healthy: 6.55±1.60; Anemia: 6.74±0.74; TM: 8.10±1.31); and duration of reverse pulmonary vein flow [Healthy: 74.0 (59.0-74.0); Anemia: 70.5 (67.0-74.0); TM: 111 (87.0-120) ms]. The mitral E/A ratio was higher in TM than Anemia (Healthy: 1.80±0.40; Anemia: 1.80±0.24; TM: 2.03±0.34). No differences were found in left ventricular structures and systolic function indexes.
CONCLUSION: Conventional Doppler echocardiography and tissue Doppler allow changes in left ventricular diastolic function to be identified in asymptomatic patients with thalassemia major.
Alexandre Rodrigues; Fábio Villaça Guimarães-Filho; João Carlos Ferreira Braga; Cássia Spínola Custódio Rodrigues; Paulo Waib; Antonio Fabron-Junior; Doralice Marvulle Tan; Ana Cristina C V França; Marina Politi Okoshi; Katashi Okoshi
Publication Detail:
Type:  Journal Article; Observational Study; Research Support, Non-U.S. Gov't     Date:  2013-01-08
Journal Detail:
Title:  Arquivos brasileiros de cardiologia     Volume:  100     ISSN:  1678-4170     ISO Abbreviation:  Arq. Bras. Cardiol.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-02-01     Completed Date:  2013-12-11     Revised Date:  2014-01-24    
Medline Journal Info:
Nlm Unique ID:  0421031     Medline TA:  Arq Bras Cardiol     Country:  Brazil    
Other Details:
Languages:  eng; por     Pagination:  75-81     Citation Subset:  IM    
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MeSH Terms
Age Factors
Anemia / etiology,  physiopathology
Blood Transfusion / adverse effects*
Chelation Therapy*
Echocardiography, Doppler / methods*
Epidemiologic Methods
Hemochromatosis / etiology,  physiopathology
Hemolysis / physiology
Iron Chelating Agents / therapeutic use*
Sex Factors
Ventricular Function*
Young Adult
beta-Thalassemia / complications*,  physiopathology,  therapy
Reg. No./Substance:
0/Iron Chelating Agents
Comment In:
Arq Bras Cardiol. 2013 Jul;101(1):93-4   [PMID:  23917509 ]

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