Document Detail


Relation between iron-overload indices, cardiac echo-Doppler, and biochemical markers in thalassemia intermedia.
MedLine Citation:
PMID:  18638603     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Cardiovascular impairment is a major cause of morbidity and mortality in patients with thalassemia intermedia. In this study, echocardiographic assessment of left heart condition was performed in patients with thalassemia intermedia, and its relation to hematologic variables--amino terminal pro-brain natriuretic peptide (NT-proBNP), ferritin, hemoglobin--and liver iron concentration (LIC) was investigated. Echocardiographic assessment was performed using pulse-wave Doppler and tissue Doppler imaging. Data from 74 patients with thalassemia intermedia--35 men, 39 women, mean age 26.5 years (8 to 63)--were randomly selected and evaluated. Blood samples were collected for NT-proBNP levels in a random subgroup of 19 patients. Mean baseline values were hemoglobin 8.4 g/dl (4.9 to 13.1), serum ferritin 902.6 ng/ml (15 to 4,140), LIC 9.0 mg Fe/g (0.5 to 32.1), and NT-proBNP 113.5 pg/ml (16.4 to 371). Correlation between LIC and pulmonary artery systolic pressure was significant, suggesting that iron loading in the liver is indicative of cardiovascular sequelae. NT-proBNP was significantly correlated with the ratio of the left ventricular early rapid filling wave to early diastolic velocity at the mitral annulus (r = 0.50, p = 0.04) and hemoglobin (r = -0.49, p = 0.03), but not with other characteristics assessed. In conclusion, this study has highlighted the importance of using tissue Doppler imaging rather than pulse-wave Doppler to characterize left ventricular diastolic dysfunction in patients with thalassemia intermedia. Demonstration of the correlation of LIC and pulmonary artery systolic pressure independent of left ventricular filling pressures supports our hypothesis that left ventricular diastolic dysfunction does not contribute to the increased pulmonary artery systolic pressure in patients with thalassemia intermedia.
Authors:
Hussain Isma'eel; Abdul Hamid El Chafic; Fuad El Rassi; Adlette Inati; Susan Koussa; Rose Daher; Walid Gharzuddin; Samir Alam; Ali Taher
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2008-05-29
Journal Detail:
Title:  The American journal of cardiology     Volume:  102     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-07-21     Completed Date:  2008-09-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  363-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine Hematology-Oncology Division, American University of Beirut, Medical Center, Beirut, Lebanon.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Blood Pressure
Child
Echocardiography, Doppler*
Female
Ferritins / blood
Hemoglobins / analysis
Humans
Iron / analysis
Iron Overload*
Liver / chemistry
Male
Middle Aged
Natriuretic Peptide, Brain / blood
Peptide Fragments / blood
Pulmonary Artery
Thalassemia / blood*,  physiopathology*
Ventricular Dysfunction, Left / physiopathology
Chemical
Reg. No./Substance:
0/Hemoglobins; 0/Peptide Fragments; 0/pro-brain natriuretic peptide (1-76); 114471-18-0/Natriuretic Peptide, Brain; 7439-89-6/Iron; 9007-73-2/Ferritins

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