Echocardiographic evaluation of systolic and diastolic heart function in patients suffering from beta-thalassemia major aged 5-10 years at the Zahedan Research Center for

Noori, Noor Mohammad; Mehralizadeh, Semira

doi:10.5152/akd.2010.041

Cited by 15 publications

(10 citation statements)

References 16 publications

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“…(19) Hemolytic anemia in thalassemia is also caused by unstable hemoglobin variants, (20) and heme iron released from hemolysis has been consistently associated with an increased risk of coronary heart diseases and cardiovascular mortality. (21) Other potential causes of hyperferritinemia are anoxia as a consequence of low hemoglobin level in the blood of patients with thalassemia. Ferritin concentration increases in response to stresses, such as anoxia.…”

Section: Resultsmentioning

confidence: 99%

Lack of correlation between non-labile iron parameters, total carbonyl and malondialdehyde in major thalassemia

Al‐Hakeim

Auda

Ali

2014

J. Clin. Biochem. Nutr.

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Thalassemia patients are at high risk of iron-induced toxicity and oxidative stress consequences. The present cross-sectional study is conducted to determine whether or not lipid peroxidation or protein oxidation is correlated with iron parameters in patients with thalassemia major. To prove this hypothesis, malondialdehyde and total carbonyl were correlated with the degree of excess iron concentration in the patients. A total of 118 Arabic Iraqi patients and 30 healthy children were participated in the present study. Results showed a significant increase (p<0.05) in serum total carbonyls, malondialdehyde and the iron indices of patients as compared with the control group. Total iron binding capacity and transferrin concentrations decreased significantly (p<0.05) in patients with thalassemia compared with the control group. The results also showed a lack of a significant correlation between each serum malondialdehyde and total carbonyl with each component of iron status. In conclusion, total carbonyls and malondialdehyde were increased in thalassemia patients indicating the vulnerability of these patients to tissue injury caused by oxidative stress. The formation of total carbonyl and malondialdehyde are independent of excess non-labile iron concentration, indicating that different mechanisms are involved in injury caused by the labile iron and in the formation of oxidation end products.

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Section: Resultsmentioning

confidence: 99%

Lack of correlation between non-labile iron parameters, total carbonyl and malondialdehyde in major thalassemia

Al‐Hakeim

Auda

Ali

2014

J. Clin. Biochem. Nutr.

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“…We found that the risk of atrial and ventricular arrhythmias was increased in the patients with both congenital heart disease and pulmonary hypertension (4). It seems that in addition to iron overload, myocardial fibrosis, structural changes, and ventricular hypertrophy secondary to chronic anemia lead to heart failure in these patients (5). However, the early detection and treatment of heart failure due to any reason in patients with thalassemia major improve the prognosis and increase the life expectancy.…”

Section: Introductionmentioning

confidence: 99%

Comparison of QT Dispersion With Left Ventricular Mass Index in Early Diagnosis of Cardiac Dysfunction in Patients With β-Thalassemia Major

Noori

Mahjoubifard

Mohammadi

et al. 2014

Iran Red Crescent Med J

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Background:In electrocardiography (ECG), QT is the interval between the onset of Q wave to the end of the T wave. This interval may be a sign of changes in the ventricular structure in hematologic disorders such as thalassemia major.Objectives:The main goal of this study was to compare the diagnostic value of corrected QT dispersion (QTcd) and QT dispersion (QTd) with left ventricular mass (LVM) and left ventricular mass index (LVMI) as well as to determine their sensitivity and specificity in early detection of the cardiac involvement in patients with β-thalassemia major.Patients and Methods:In a case-control study, 60 patients older than ten years of age with thalassemia major who received regular blood transfusion and iron chelators were selected as the case group and were compared with 60 healthy age- and sex-matched subjects. All patients had myocardial performance index (MPI) of more than 0.5 and MPI for controls was less than 0.5. Echocardiography and ECG were performed for both groups and data were analyzed using appropriate statistical tests.Results:The mean age of cases and controls were 16 ± 2.8 and 16.08 ± 3.01 years, respectively. Male to female ratio was 33:27 in case group and 31:29 in the control group. LVMI in the case group was greater than control group. QTd and QTcd were larger in case group than in control group. The sensitivity and specificity of LVM, LVMI, QTd, and QTcd were as follows: 88.3%, 77.1%; 86.7%, 80%; 93.8%, 80%; and 91.7%, 86.7%, respectively.Conclusions:This study showed acceptable sensitivity and specificity of QTcd and QTd in comparison to LVMI; it seems that standard ECG can be used for early diagnosis of cardiac involvement in asymptomatic patients with thalassemia major.

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“…Although systolic dysfunction is investigated more commonly, reports about diastolic dysfunction are increasing [5][6][7].…”

Section: Cardiac Parameters In Thalassemia Major mentioning

confidence: 99%

Assessment of Cardiac Parameters in Evaluation of Cardiac Functions in Patients with Thalassemia Major

Öztarhan

Delibas

Salcioglu

et al. 2012

Pediatric Hematology and Oncology

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The aim of the study was to evaluate cardiac function and early cardiac dysfunction of patients followed as thalassemia major. In this study, the authors compared 100 patients, diagnosed as thalassemia major with mean age 11.84 ± 4.35, with 60 healthy control subjects at the same age between 2008 and 2011. Early diagnosis of iron overload that may occur after repeated transfusions is important in this patient group. To detect early iron accumulation, the authors compared ferritin with the echo findings, the 24-hour Holter, and cardiac magnetic resonance imaging (MRI) T2* values in the patients of same age and sex, treated with chelators, without heart failure, nonsplenectomized, and do not differ in the presence of hepatitis C. Ferritin levels, left ventricular systolic functions (ejection fraction [EF], shortening fraction [SF]), left ventricular measurements, left ventricular diastolic functions, T2* image on cardiac magnetic resonance, heart rate variables in 24 hours, and Holter rhythm were evaluated to show the early failure of cardiac functions. In this study the authors confirmed that iron-related cardiac toxicity damages electrical activity earlier than myocardial contractility. Left ventricular diastolic diameter (LVDd), left ventricular mass (LVM), and LV systolic diameter (LVDs) levels were significantly higher in the patient group with ectopia. Patients with ectopia are the ones in whom LVM and LVDd are increased. In thalassemia major patients with ectopia, LF/HF ratio was markedly increased, QTc dispersion was clearly found higher in patients with ectopia rather than nonectopic patients. The standard deviation all normal RR interval series (SDNN) was found clearly lower in thalassemia major group with ectopia than control group because it is assumed that increase in cardiac sympathetic neuronal activity is related to exposure to chronic diastolic and systolic failure.

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Echocardiographic evaluation of systolic and diastolic heart function in patients suffering from beta-thalassemia major aged 5-10 years at the Zahedan Research Center for

Cited by 15 publications

References 16 publications

Lack of correlation between non-labile iron parameters, total carbonyl and malondialdehyde in major thalassemia

Lack of correlation between non-labile iron parameters, total carbonyl and malondialdehyde in major thalassemia

Comparison of QT Dispersion With Left Ventricular Mass Index in Early Diagnosis of Cardiac Dysfunction in Patients With β-Thalassemia Major

Assessment of Cardiac Parameters in Evaluation of Cardiac Functions in Patients with Thalassemia Major

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