Left ventricular diastolic Doppler characteristics in beta-thalassemia major.

Kremastinos, Dimitrios Th.; Tsiapras, Dimitrios; Tsetsos, George; Rentoukas, Elias; Vretou, H P; Toutouzas, Pavlos

doi:10.1161/01.cir.88.3.1127

Cited by 158 publications

(143 citation statements)

References 40 publications

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“…Cardiac involvement can also be monitored by echocardiography (M-mode, PW Doppler, and TDI). Diastolic dysfunction usually precedes systolic dysfunction and is mainly attributed to iron deposition in the heart (22). Iron overload may lead to apoptosis, fibrosis, and oxidative stress in the myocardial tissues, and therefore, diastolic functions may be impaired (2).…”

Section: Discussionmentioning

confidence: 99%

The relation of color m-mode flow propagation with cardiac iron load in patients with thalassemia major

Özbek

Acar²,

Kayrak³

et al. 2011

Diagn Interv Radiol

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Section: Discussionmentioning

confidence: 99%

The relation of color m-mode flow propagation with cardiac iron load in patients with thalassemia major

Özbek

Acar²,

Kayrak³

et al. 2011

Diagn Interv Radiol

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“…Echocardiographic assessment of the HR-corrected E/A ratio is also a useful measure of diastolic dysfunction (where E/A ratio is the ratio of early peak velocity of mitral diastolic flow [E wave] and the late peak velocity of mitral diastolic flow from atrial contraction [A wave]). 35,36 Indeed, HR-corrected E/A ratios were increased in the iron-overload mice when measured with either ketamine/xylazine or isoflurane/oxygen …”

Section: Clinical and Cardiovascular Effects Of Iron Overloadmentioning

confidence: 98%

Taurine Supplementation Reduces Oxidative Stress and Improves Cardiovascular Function in an Iron-Overload Murine Model

et al. 2004

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Background-Iron overload has an increasing worldwide prevalence and is associated with significant cardiovascular morbidity and mortality. Elevated iron levels in the myocardium lead to impaired systolic and diastolic function and elevated oxidative stress. Taurine accounts for 25% to 50% of the amino acid pool in myocardium, possesses antioxidant properties, and can inhibit L-type Ca 2ϩ channels. Thus, we hypothesized that this agent would reduce the cardiovascular effects of iron overload. Methods and Results-Iron-overloaded mice were generated by intraperitoneal injection of iron either chronically (5 days per week for 13 weeks) or subacutely (5 days per week for 4 weeks). Iron overload causes increased mortality, elevated oxidative stress, systolic and diastolic dysfunction, hypotension, and bradycardia. Taurine supplementation increased myocardial taurine levels by 45% and led to reductions in mortality and improved cardiac function, heart rate, and blood pressure in iron-overloaded mice. Histological examination of the myocardium revealed reduced apoptosis and interstitial fibrosis in iron-overloaded mice supplemented with taurine. Taurine mediated reduced oxidative stress in iron-overloaded mice along with attenuation of myocardial lipid peroxidation and protection of reduced glutathione level. Conclusions-These results demonstrate that treatment with taurine reduces iron-mediated myocardial oxidative stress, preserves cardiovascular function, and improves survival in iron-overloaded mice. The role of taurine in protecting reduced glutathione levels provides an important mechanism by which oxidative stress-induced myocardial damage can be curtailed. Taurine, as a dietary supplement, represents a potential new therapeutic agent to reduce the cardiovascular burden from iron-overload conditions.

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“…Thus, the prognostic significance of diastolic echocardiographic findings has been questioned even in TM. 14 The E/A ratio, however, which is one of the most widely used criteria for restrictive LV filling, was significantly increased in TM both in fit patients and in those with evident heart disease, probably representing the effect of iron overload. 15 In our study, the main difference of β-TM patients vs. controls was restrictive diastolic filling pattern, even when they were asymptomatic and had normal LV function.…”

Section: Discussionmentioning

confidence: 99%

“…16 However, the value of monitoring cardiac function to the long-term management of TM remains unclear, which is partly because the prognostic significance of diastolic abnormalities, which appear early in the disease process, is unknown. 14 Additionally, once congestive heart failure was present, systolic abnormalities were evident by echocardiography.…”

Section: Discussionmentioning

confidence: 99%

Marcadores eletrocardiográficos para detecção precoce de doença cardíaca em pacientes com talassemia beta maior

Nişli¹,

Yavuz²,

Naci³

et al. 2010

J. Pediatr. (Rio J.)

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Objective: To comparatively evaluate P-wave dispersion (PWD) in patients with β-thalassemia major (TM) and healthy control subjects for the early prediction of arrhythmia risk.Methods: Eighty-one children with β-TM, aged 4-19 years, and 74 healthy children (control group) underwent routine electrocardiography and transthoracic echocardiography for cardiac evaluation. PWD was calculated as the difference between the maximum and the minimum P-wave duration.Results: There was a statistically significant difference between study and control groups in peak early (E) mitral inflow velocity and E/late (A) velocity ratio. Maximum P-wave duration and PWD were found to be significantly higher in β-TM patients than in control subjects. Conclusions:Increased PWD in our β-TM patients might be related to depression of intra-atrial conduction due to atrial dilatation and increased sympathetic activity. These patients should be closely followed up for risk of lifethreatening arrhythmias.J Pediatr (Rio J). 2010;86(2):159-162: Thalassemia major, P-wave dispersion, ferritin, cardiac involvement. Original article0021-7557/10/86-02/159 Jornal de PediatriaCopyright © 2010 by Sociedade Brasileira de Pediatria IntroductionCardiac failure and sudden death, the latter probably due to arrhythmias, remain the major causes of death in β-thalassemia major (TM). 1 Disease prognosis, however, has been modified with regular blood transfusions and iron chelation therapy with deferoxamine. 2 P-wave dispersion (PWD) is a simple electrocardiographic marker that has been reported to be associated with inhomogeneous and discontinuous propagation of sinus impulses. It has been defined as the difference between the maximum and the minimum P-wave duration. 3-4 Prolonged P-wave duration and increased PWD have been shown to carry an increased risk for atrial fibrillation. 4 Cardiomyopathy is associated with a four-to six-fold increase in the risk of developing atrial fibrillation. 5 The present study aimed to comparatively investigate these electrocardiographic markers in patients with β-TM and healthy control subjects for the early prediction of arrhythmia risk. MethodsThe study population consisted of two groups: Group I -81 children with β-TM; and group II -74 healthy children Peak mitral inflow velocities in early diastole (E) and after atrial contraction (A) were expressed as cm/s. Deceleration time of peak E filling velocity was measured in milliseconds.Overall LV diastolic dysfunction was defined as the presence of any abnormality of the mitral valve. Twelve-lead electrocardiogram (ECG) was recordedfor each patient and control subject at a rate of 50 mm/s.At the time of electrocardiographic recording, all subjects were in sinus rhythm and none were taking any type of antiarrhythmic agent. P-wave duration was measured manually by two of the investigators who were blinded to the participants' clinical status. All measurements were performed using calipers and magnifying lens to improve accuracy. The onset of P-wave was defined as the junctio...

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Left ventricular diastolic Doppler characteristics in beta-thalassemia major.

Cited by 158 publications

References 40 publications

The relation of color m-mode flow propagation with cardiac iron load in patients with thalassemia major

The relation of color m-mode flow propagation with cardiac iron load in patients with thalassemia major

Taurine Supplementation Reduces Oxidative Stress and Improves Cardiovascular Function in an Iron-Overload Murine Model

Marcadores eletrocardiográficos para detecção precoce de doença cardíaca em pacientes com talassemia beta maior

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