Early Identification of Cardiovascular Involvement in Patients With β-Thalassemia Major

Piccione, Maurizio Cusmà; Piraino, Beth; Zito, Concetta; Khandheria, Bijoy K.; Bella, Gianluca Di; Gregorio, Cesare de; Oreto, Lilia; Rigoli, Luciana; Ferraù, Valeria; Salpietro, Carmelo; Carerj, Scipione

doi:10.1016/j.amjcard.2013.05.080

Cited by 45 publications

(22 citation statements)

References 29 publications

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“…20 Previous studies have demonstrated possible clinical applications of this software, highlighting the feasibility of vascular function assessment in different clinical conditions. 38,[46][47][48] Our results confirm those from other studies that used the same system and showed an inverse relationship between diastolic function and echo-tracking parameters (elastic modulus, b stiffness and PWV) in diabetes patients, normal individuals and patients with different diseases. 49,50 Limitations Study population size was relatively small, particularly the subgroup with grade I diastolic dysfunction; this impairs the capacity to generalize our findings.…”

Section: Discussionsupporting

confidence: 88%

Interplay between arterial stiffness and diastolic function

Zito

Mohammed

Todaro

et al. 2014

Journal of Cardiovascular Medicine

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Section: Discussionsupporting

confidence: 88%

Interplay between arterial stiffness and diastolic function

Zito

Mohammed

Todaro

et al. 2014

Journal of Cardiovascular Medicine

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“…Our data show that the CIMT of thalassemic patients was significantly increased compared to controls. This finding is supported by the results of some previous studies;16–18 Cheung et al,19 found an increase in the CIMT in patients with BTM compared to controls, Tantawy et al, 200917 and Gullu et al,18 found the same results in their study, and Adly et al19 reported that Carotid IMT measurements were significantly but slightly higher in the BTM group than that in the controls (0.57 ± 0.07 vs. 0.54 ± 0.04, P = 0.04) and that CIMT is increased in patients with BTM. On the other hand, a previous study, carried out by Cusmà et al,20 comparing the CIMT between the thalassemic patients and healthy subjects (0.67 ± 0.20 mm vs. 0.66 ± 0.15 mm), showed no significant difference.…”

Section: Discussionsupporting

confidence: 91%

The Role of the Carotid Doppler Examination in the Evaluation of Atherosclerotic Changes in Beta Thalassemia Patients

Hakeem

Samei

Shereif

et al. 2015

Mediterr J Hematol Infect Dis

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BackgroundIron overload in patients with beta-thalassemia major (BTM) lead to alterations in the arterial structures and the thickness of the carotid arteries. Doppler ultrasound scanning of extra-cranial internal carotid arteries is non-invasive and relatively quick to perform and may identify children at increased risk of stroke that would otherwise be missed. Increased carotid artery intima media thickness (CIMT) is a structural marker for early atherosclerosis and correlates with the vascular risk factors and to the severity and extent of coronary artery disease.ObjectiveTo evaluate the role of carotid Doppler examination and CIMT measurement as a predictor of atherosclerotic changes in BTM children with iron overload.Patients and MethodsSixty two children with BTM and, thirty age and sex matched normal controls were included. Complete blood count, ferritin, serum cholesterol were done, as well as carotid Doppler ultrasonography to measure the CIMT in both patients and controls.ResultsCIMT of thalassemic patients was significantly increased compared to controls (p=0.001). There was a significant positive correlation between CIMT and patient’s age, the duration from first blood transfusion, serum cholesterol and, iron overload parameters as serum ferritin, frequency of blood transfusion, iron chelation. The length of the transfusion period was the highest risk factor, and an inadequate iron chelation was a further risk factor. Significant negative correlation was found between CIMT and hematocrit value while no significant correlation was found between CIMT and weight, height, BMI centiles and Hb level.ConclusionCarotid Doppler is very useful in measurement of CIMT that increased in thalassemic patients that shows a strong relationship with features of iron overload. Routine Doppler measurement of CIMT in these patients is recommended to predict early atherosclerotic changes as well as in follow-up.

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“…Longitudinal, circumferential, and radial strain values at the left ventricle in BTM patients and control groups were studied previously. While Piccione et al . showed that the global left ventricle longitudinal strain was significantly impaired in the patients compared with the controls, they could not detect differences in the radial and circumferential strain values between the patient and control groups.…”

Section: Discussionmentioning

confidence: 83%