TY - JOUR
TI - The effect of iron overload in the hearts of patients with
beta-thalassemia
AU - Brili, SV
AU - Tzonou, AI
AU - Castelanos, SS
AU - Aggeli, CJ and
AU - Tentolouris, CA
AU - Pitsavos, CE
AU - Toutouzas, PK
JO - Clinical Cardiology
PY - 1997
VL - 20
TODO - 6
SP - 541-546
PB - Wiley
SN - 0160-9289, 1932-8738
TODO - 10.1002/clc.4960200607
TODO - beta-thalassemia; atrial natriuretic peptide; ferritin
TODO - Background and hypothesis: An important complication of beta-thalassemia
is iron deposition in cardiac tissues resulting in fibrosis and
dysfunction. Our aim was the investigation of the possible clinical
effect of iron loading in the heart of patients with beta-thalassemia
prior to the appearance of symptoms of depressed systolic function.
Methods: Thirty-five patients with beta-thalassemia, of whom 24 had the
major type (Group 1) and 11 had the intermedia type (Group 2) were
studied. Eleven age- and gender-matched controls were also studied
(Group 3). All patients were evaluated echocardiographically and were
shown to have normal left ventricular systolic function and dimensions.
Serum ferritin, atrial natriuretic peptide (ANP), left atrial diameter
(LAD), peak early mitral inflow velocity (E), peak late mitral inflow
velocity(A), E/A ratio, deceleration time of the mitral inflow E wave
(DT), and isovolumic relaxation time (IVRT) were measured.
Results: Univariate analysis showed that both groups of patients had
similarly increased LAD and ANP plasma lev els. Group 1 had a higher E/A
ratio (2.27 +/- 0.88) SS than Group 2(1.69 +/- 0.47, p = 0.05) and Group
3 (1.50 +/- 0.38, p = 0.01). Serum ferritin was significantly higher in
Group 1 (3.526 +/- 0.352) than in Group 2 (2.808 +/- 0.288, p < 10(-5))
and Group 3 (2.139 +/- 0.124, p<10(-5)).Multivariate analysis showed
that ANP is a factor that is affected by the LAD and E/A ratio and that
serum ferritin levels affect the LAD and E/A ratio.
Conclusions: Although LAD and ANP levels are increased in patients with
beta-thalassemia, the increased serum ferritin levels of patients seem
to affect left atrial size and E/A ratio. ANP secretion is consecutively
affected by these factors.
ER -