Περίληψη:
Despite intense iron-chelation therapy, the life expectancy of patients
with beta-thalassemia major (beta-TM) is still limited by the occurrence
of heart failure. In the present study, we sought to evaluate the
prognostic significance of several clinical factors on the outcome of
heart failure or arrhythmias in patients with beta-TM. The study group
consisted of 131 consecutive young patients with beta-TM (71 men aged 21
+/- 4 years, 60 women aged 22 5 years) who were initially examined
during 1995. The clinical and vital statuses of all patients were
biannually reviewed from 1995 to 2004. Cox proportional hazards models
were used to evaluate the association of the occurrence of death or
nonfatal events due to heart failure or arrhythmias with clinical
factors (systolic and diastolic blood pressures), echocardiographic
factors (left and right ventricular diameters, left atrial and aortic
root dimensions, left ventricular ejection fraction),
electrocardiographic factors (T-wave inversion in leads V1-V3, QRS
duration, heart rate), and serum ferritin levels, after controlling for
age, sex, and body mass index. During the follow-up, I I men (16%) and
5 women (8%) had an event (men versus women, P = .212). The
age-adjusted event rate was 16 events per 913 person-years (2%). The
presence of T-wave inversion in right precordial leads (hazard ratio =
3.06; 95 % confidence interval [CI], 1.1-8.8), increased heart rate
(hazard ratio = 1.28; 95% CI, 1.03-1.58), decreased aortic root
diameter (hazard ratio = 0.84; 95% CI, 0.73-0.96), and decreased
ejection fraction (hazard ratio per 1% change = 0.95; 95% CI,
0.91-0.99) were associated with a higher risk for a cardiac event. We
revealed that the presence of T-wave inversions, increased heart rate,
low ejection fraction of the left ventricle, and decreased aortic root
diameter appear to confer higher risk for cardiac events in young
patients with beta-TM. (C) 2004 The Japanese Society of Hematology.
Συγγραφείς:
Chrysohoou, C
Panagiotakos, DB
Barbetseas, Y
Brilli, S and
Lambrou, S
Karagiorga, M
Ladis, VA
Pitsavos, C and
Stefanadis, C
