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Assessment of Myocardial Performance Index and Aortic Elasticity in Patients With Beta-Thalassemia Major.

Sahin C, Basaran O, Altun I, Akin F, Topal Y, Topal H, Biteker M, Azik MF - J Clin Med Res (2015)

Bottom Line: Aortic elasticity indices were significantly higher while aortic strain and distensibility values were significantly lower in patients with beta-thalassemia compared to controls (all P values < 0.001).Positive correlations were detected between aortic stiffness index and platelet (r = 0.235; P = 0.019) and ferritin values (r = 0.328; P = 0.008).Presence of thalassemia (β = -0.729; P = 0.041) and higher platelet value (β = 0.235; P = 0.019) were significant determinants for increased aortic stiffness in linear regression analysis.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey.

ABSTRACT

Background: This study aimed to assess myocardial performance index (MPI) and arterial elasticity indices in asymptomatic patients with beta-thalassemia major without known heart disease and to determine relationship between these indices and parameters indicating iron load of body.

Methods: The study included 55 asymptomatic beta-thalassemia patients (median age: 20 years (10 - 48 years)) without known history of heart disease and 40 age- and sex-matched healthy controls. MPI and arterial elasticity indices were determined by using standard two-dimensional and Doppler echocardiography. Data were analyzed by SPSS for Windows version 20.0 (SPSS Inc., Chicago, IL, USA).

Results: Left ventricular mass index (83.917 (50.62 - 144) and 68.37 (41.9 - 113.3)) and MPI (0.464 (0.33 - 0.68) and 0.431 (0.31 - 0.51)) were significantly higher in patients with beta-thalassemia when compared to control group (P < 0.001 and P = 0.006). Aortic elasticity indices were significantly higher while aortic strain and distensibility values were significantly lower in patients with beta-thalassemia compared to controls (all P values < 0.001). Positive correlations were detected between aortic stiffness index and platelet (r = 0.235; P = 0.019) and ferritin values (r = 0.328; P = 0.008). Presence of thalassemia (β = -0.729; P = 0.041) and higher platelet value (β = 0.235; P = 0.019) were significant determinants for increased aortic stiffness in linear regression analysis.

Conclusion: Arterial elasticity indices and MPI are impaired in patients with beta-thalassemia major and these parameters may be used to predict cardiovascular complications in asymptomatic patients with beta-thalassemia major.

No MeSH data available.


Related in: MedlinePlus

Correlation curve between aortic stiffness index and ferritin.
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Figure 1: Correlation curve between aortic stiffness index and ferritin.

Mentions: Thoracic aortic diameters (cm) were measured 3 cm above the aortic valve by two-dimensional guided M-mode transthoracic echocardiography of the aortic root at left parasternal long-axis view (Fig. 1). Aortic systolic diameter (AoS) was measured at the time of full opening of the aortic valve, and diastolic diameter (AoD) at the peak of the QRS complex at the simultaneous electrocardiogram recording. Inner aortic diameters were measured with a caliper in systole and diastole as the distance between the trailing edge of the anterior aortic wall and the leading edge of the posterior aortic wall. Measurements were repeated at three cardiac cycles and the averaged value was used for analysis. All echocardiographic measurements were made by a cardiologist blinded to the study protocol. The elasticity of the aorta was assessed by the following formulas: Aortic strain (%) = (AoS - AoD) × 100/AoD; aortic distensibility (cm2dyn-110-3) = (2 × aortic strain)/PP; aortic stiffness index = (ln (systolic pressure/diastolic pressure))/aortic strain; and elastic modulus E(p) = PP/strain [8]. Stiffness index is a marker for aortic stiffness, whilst strain, distensibility and elastic modulus are markers for aortic elasticity. These parameters give information on structure of aorta. Abnormality in these parameters means structural alteration of arterial wall. Elastic properties of aorta are useful not only in representing basic mechanical behavior of the arterial system but also in predicting outcome.


Assessment of Myocardial Performance Index and Aortic Elasticity in Patients With Beta-Thalassemia Major.

Sahin C, Basaran O, Altun I, Akin F, Topal Y, Topal H, Biteker M, Azik MF - J Clin Med Res (2015)

Correlation curve between aortic stiffness index and ferritin.
© Copyright Policy - open access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4554220&req=5

Figure 1: Correlation curve between aortic stiffness index and ferritin.
Mentions: Thoracic aortic diameters (cm) were measured 3 cm above the aortic valve by two-dimensional guided M-mode transthoracic echocardiography of the aortic root at left parasternal long-axis view (Fig. 1). Aortic systolic diameter (AoS) was measured at the time of full opening of the aortic valve, and diastolic diameter (AoD) at the peak of the QRS complex at the simultaneous electrocardiogram recording. Inner aortic diameters were measured with a caliper in systole and diastole as the distance between the trailing edge of the anterior aortic wall and the leading edge of the posterior aortic wall. Measurements were repeated at three cardiac cycles and the averaged value was used for analysis. All echocardiographic measurements were made by a cardiologist blinded to the study protocol. The elasticity of the aorta was assessed by the following formulas: Aortic strain (%) = (AoS - AoD) × 100/AoD; aortic distensibility (cm2dyn-110-3) = (2 × aortic strain)/PP; aortic stiffness index = (ln (systolic pressure/diastolic pressure))/aortic strain; and elastic modulus E(p) = PP/strain [8]. Stiffness index is a marker for aortic stiffness, whilst strain, distensibility and elastic modulus are markers for aortic elasticity. These parameters give information on structure of aorta. Abnormality in these parameters means structural alteration of arterial wall. Elastic properties of aorta are useful not only in representing basic mechanical behavior of the arterial system but also in predicting outcome.

Bottom Line: Aortic elasticity indices were significantly higher while aortic strain and distensibility values were significantly lower in patients with beta-thalassemia compared to controls (all P values < 0.001).Positive correlations were detected between aortic stiffness index and platelet (r = 0.235; P = 0.019) and ferritin values (r = 0.328; P = 0.008).Presence of thalassemia (β = -0.729; P = 0.041) and higher platelet value (β = 0.235; P = 0.019) were significant determinants for increased aortic stiffness in linear regression analysis.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey.

ABSTRACT

Background: This study aimed to assess myocardial performance index (MPI) and arterial elasticity indices in asymptomatic patients with beta-thalassemia major without known heart disease and to determine relationship between these indices and parameters indicating iron load of body.

Methods: The study included 55 asymptomatic beta-thalassemia patients (median age: 20 years (10 - 48 years)) without known history of heart disease and 40 age- and sex-matched healthy controls. MPI and arterial elasticity indices were determined by using standard two-dimensional and Doppler echocardiography. Data were analyzed by SPSS for Windows version 20.0 (SPSS Inc., Chicago, IL, USA).

Results: Left ventricular mass index (83.917 (50.62 - 144) and 68.37 (41.9 - 113.3)) and MPI (0.464 (0.33 - 0.68) and 0.431 (0.31 - 0.51)) were significantly higher in patients with beta-thalassemia when compared to control group (P < 0.001 and P = 0.006). Aortic elasticity indices were significantly higher while aortic strain and distensibility values were significantly lower in patients with beta-thalassemia compared to controls (all P values < 0.001). Positive correlations were detected between aortic stiffness index and platelet (r = 0.235; P = 0.019) and ferritin values (r = 0.328; P = 0.008). Presence of thalassemia (β = -0.729; P = 0.041) and higher platelet value (β = 0.235; P = 0.019) were significant determinants for increased aortic stiffness in linear regression analysis.

Conclusion: Arterial elasticity indices and MPI are impaired in patients with beta-thalassemia major and these parameters may be used to predict cardiovascular complications in asymptomatic patients with beta-thalassemia major.

No MeSH data available.


Related in: MedlinePlus