Τίτλος:
Correlation of NT-proBNP levels and cardiac iron concentration in
patients with transfusion-dependent thalassemia major
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Iron-induced cardiotoxicity remains the leading cause of morbidity and
mortality in patients with transfusion-dependent beta-thalassemia major.
Heart failure in these patients, which may be reversible but has a poor
prognosis, is characterized by myocardial iron deposition-related early
diastolic dysfunction. Amino-terminal pro-brain natriuretic peptide
(NT-proBNP) is a sensitive biomarker for the detection of asymptomatic
left ventricular dysfunction. In this study, we prospectively evaluated
plasma NT-proBNP levels in 187 adult patients aged 19-54 years with
beta-TM. Possible correlations with the proposed recently cardiac iron
concentration based on an equation derived from heart T2* assessment
by MRI: [Fe] = 45.0 x [T2*](-1.22) with [Fe] in milligrams per
gram dry weight and T2* in milliseconds were explored. We found that:
143 patients had no cardiac hemosiderosis, defined as [Fe]<1.1 mg/g
dry weight, corresponding to T2*>20 ms and 44 patients had cardiac
hemosiderosis, defined as [Fe]>1.2 mg/g dry weight. The main results
of the study showed that: a) NT-proBNP levels were markedly increased in
thalassemic patients (152.2 +/- 190.1 pg/mL, ranged from 6.0 to 1336.0
pg/mL compared to normal control levels 40.1 +/- 19.7 pg/ml, p<0.001, b)
NT-proBNP levels were significantly higher in patients with cardiac
hemosiderosis compared to patients without cardiac hemosiderosis (185.1
+/- 78.0 vs 128.9 +/- 20.2 pg/mL, p<0.05), c) NT-proBNP levels
correlated with [Fe] values (r = 0.387, p<0.001). This correlation was
significant in patients with cardiac hemosiderosis (r = 0.520, p<0.001),
but not in patients without cardiac hemosiderosis (p>0.1), and d) no
significant correlation was found between NT-proBNP levels and left
ventricular ejection fraction values, (p>0.3). Our study demonstrated
for first time the significant association of NT-proBNP levels and
cardiac iron concentration in patients with beta-thalassemia major
linking blood chemistry and imaging techniques. Multicenter studies of
these parameters during iron chelation therapies are needed to validate
their association and further exploit its clinical use. (C) 2012
Elsevier Inc. All rights reserved.
Συγγραφείς:
Delaporta, Polyxeni
Kattamis, Antonios
Apostolakou, Filia and
Boiu, Sorina
Bartzeliotou, Anastasia
Tsoukas, Evangelos and
Papassotiriou, Ioannis
Περιοδικό:
BLOOD CELLS MOLECULES AND DISEASES
Εκδότης:
ACADEMIC PRESS INC ELSEVIER SCIENCE
Λέξεις-κλειδιά:
Thalassemia major; NT-proBNP; Heart failure; Cardiac iron concentration
DOI:
10.1016/j.bcmd.2012.09.002
