NT‐proBNP levels and diastolic dysfunction in β‐Thalassaemia major patients

Kremastinos, Dimitrios Th.; Tsiapras, Dimitrios; Κωστοπούλου, Άννα; Hamodraka, E.; Chaidaroglou, Antigoni; Kapsali, E.

doi:10.1016/j.ejheart.2006.11.004

Cited by 42 publications

(52 citation statements)

References 30 publications

(36 reference statements)

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“…It has been shown recently that amino-terminal pro-B-type natriuretic peptide may be used as an early index of diastolic left ventricular dysfunction in patients with thalassemia major. 1 Indeed, amino-terminal pro-B-type natriuretic peptide was found to be increased in a group of 52 patients with thalassemia major with preserved left ventricular systolic function, compared with normal controls, and that increase was evident before the conventional Doppler indices of diastolic left ventricular function became abnormal. 1 In comparison with B-type natriuretic peptide, amino-terminal pro- The measures concern all patient categories.…”

Section: Therapeutic Issuesmentioning

confidence: 99%

“…1 Indeed, amino-terminal pro-B-type natriuretic peptide was found to be increased in a group of 52 patients with thalassemia major with preserved left ventricular systolic function, compared with normal controls, and that increase was evident before the conventional Doppler indices of diastolic left ventricular function became abnormal. 1 In comparison with B-type natriuretic peptide, amino-terminal pro- The measures concern all patient categories. ¶Combination regimens (oral and subcutaneous) or constant infusion (subcutaneous or intravenous).…”

Section: Therapeutic Issuesmentioning

confidence: 99%

“…However, immigration of those populations to USA., Canada, and Western European countries has resulted in a more universal distribution of the disease. [1][2][3] Therefore, ␤-thalassemia should currently be considered a global rather than a regional health problem.…”

Section: ␤-Thalassemia: a Geographical And Historical Perspectivementioning

confidence: 99%

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β-Thalassemia Cardiomyopathy

Kremastinos

Farmakis

Aessopos

et al. 2010

Circ: Heart Failure

176

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Abstract-␤-Thalassemia is an inherited hemoglobin disorder resulting in chronic hemolytic anemia that typically requires life-long transfusion therapy. Although traditionally prevalent in the Mediterranean basin, Middle East, North India, and Southeast Asia, immigration of those populations to North America and Western Europe has rendered ␤-thalassemia a global health problem. Cardiac complications represent the primary cause of mortality and one of the major causes of morbidity in those patients. Heart disease is mainly expressed by a particular cardiomyopathy that progressively leads to heart failure and death. The ␤-thalassemia cardiomyopathy is mainly characterized by 2 distinct phenotypes, a dilated phenotype, with left ventricular dilatation and impaired contractility and a restrictive phenotype, with restrictive left ventricular filling, pulmonary hypertension, and right heart failure. The pathophysiology of the disorder is multifactorial, with a central role of myocardial iron overload and the significant contribution of immunoinflammatory mechanisms. Patients' management is demanding and requires a multidisciplinary approach, preferably in specialized centers. (Circ Heart Fail. 2010;3:451-458.)

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Section: Therapeutic Issuesmentioning

confidence: 99%

Section: Therapeutic Issuesmentioning

confidence: 99%

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β-Thalassemia Cardiomyopathy

Kremastinos

Farmakis

Aessopos

et al. 2010

Circ: Heart Failure

176

View full text Add to dashboard Cite

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“…The amino-terminal pro-B-type natriuretic peptide may serve as an early index of diastolic LV dysfunction in patients with iron overload. 10 Indeed, it was shown that amino-terminal pro-B-type natriuretic peptide might be elevated in thalassemia major patients with preserved LVEF before conventional Doppler indices of diastolic function became abnormal 30 or when Doppler and tissue Doppler values were inconclusive. 31 CMR-derived T2* relaxation time is currently the mainstay for the quantitative assessment of cardiac iron deposition.…”

Section: Diagnosis and Screeningmentioning

confidence: 99%

“…30,31 If the cause of iron overload persists and no proper iron chelation therapy is initiated, the majority of patients with IOC develop LV remodeling that ultimately leads to LV dilatation and reduced LVEF, the so-called dilated phenotype of IOC. 10,32 In a minority of cases (Ͻ10%) characterized by severe iron overload, restrictive LV dysfunction leads, in advanced age, to the development of pulmonary hypertension, right ventricular dilatation, and right-sided heart failure without LV anatomic remodeling and with preserved LVEF, even at the final stages, the so-called restrictive phenotype.…”

Section: Kremastinos and Farmakis Iron Overload Cardiomyopathy 2255mentioning

confidence: 99%

Iron Overload Cardiomyopathy in Clinical Practice

2011

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The pathophysiological relationship and clinical significance of left atrial function and left ventricular diastolic dysfunction in β‐thalassemia major

et al. 2013

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Iron deposition in combination with inflammatory and immunogenetic factors is involved in the pathophysiology of cardiac dysfunction in b-thalassemia major. We investigated the mechanical and endocrine function of the left atrium and ventricle to identify early signs of dysfunction. We studied 90 patients (mean age: 29 6 11 years) with b-thalassemia and normal left ventricular function and 90 age and sex-matched healthy controls. Patients and controls underwent a thorough cardiac echocardiographic study and measurements of the b-type (NTproBNP) and atrial natriuretic peptides (proANP). Patients underwent 24-hr Holter recordings for arrhythmia monitoring. In the patient group, atria were affected early during the course of the disease, prior to diastolic and systolic left ventricular dysfunction. The E/E 0 ratio (E Doppler mitral fast inflow to the corresponding tissue Doppler E) continually increased with age (P < 0.05) and reached levels indicating left ventricular diastolic dysfunction (E/E 0 > 15) in the third decade whereas indexes of active and passive atrial function decreased gradually throughout life. In controls, the E/E 0 ratio continually increased with age but with later (fifth decade) appearance of diastolic dysfunction and a compensatory increase in atrial active function. Both natriuretic peptides were significantly increased in patients compared to controls (558 6 141 and 2,580 6 1,830 fmol/mL for NT-proBNP and proANP versus 332 6 106 and 1,331 6 1,134 fmol/mL, respectively). Atrial fibrillation was found in a subgroup of 23 (26%) patients, older in age with mild diastolic function and enlarged, depressed atria. In conclusion, atrial mechanical depression seems to be a very early sign of cardiac damage. It may become echocardiographically evident even before diastolic and systolic dysfunction and is associated to supraventricular arrhythmias.

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NT‐proBNP levels and diastolic dysfunction in β‐Thalassaemia major patients

Cited by 42 publications

References 30 publications

β-Thalassemia Cardiomyopathy

β-Thalassemia Cardiomyopathy

Iron Overload Cardiomyopathy in Clinical Practice

The pathophysiological relationship and clinical significance of left atrial function and left ventricular diastolic dysfunction in β‐thalassemia major

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