Relation of Left Ventricular Diastolic Dysfunction to Serum Ferritin in Thalassemia Major
https://doi.org/10.24017/science.2019.ICHMS.24
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A prospective study was conducted on 60 thalassemia major patients (33 males and 27 females ) in whom the LV function and its parameters where assessed by echocardiography in relation to serum ferritin during the period from 2nd October 2007 to 2nd February 2008, in Sulaimani pediatric teaching hospital. Patient and method: The age ranges of patients were ranged between 3 – 18 years old. The diastolic function of LV was assessed by (M-mode, D-mode, and pulse dopplar study of mitral and pulmonary vein) done. Among 60 patients seen, 25% shows normal LV diastolic function, the rest is 13% relaxation dysfunction, 27% shows Psuedonormal diastolic dysfunction and 35% shows restrictive pattern of LV diastolic dysfunction. Mean serum ferritin in normal and abnormal diastolic LV dysfunction was not so different. In addition nearly all LV parameters as ( LVEDD , LVESD , LA diameter , aortic root diameter , IVC , E ,A ,E/A ratio , A-E time , DT time , S,D,R waves ) where non significantly related to serum ferritin level , this means that P value is less than 0.05 . This means that the level of serum ferritin has no relation with the above parameters in which 75% of those parameters were already abnormal in comparison to the age of the child. Another finding shows that 25% of normal diastolic function is seen in serum levels above 1500 ng/l, in addition, 50% of diastolic dysfunction will associate serum ferritin of less than 500ng/l . P value is more than 0,05 this means that its non-significant. In conclusion, there is a non-significant correlation between serum ferritin and LV diastolic function, so serum ferritin is not a dependant indicator for myocardial iron deposition.
Keywords:
Ventricle, Thalassemia , Diastolic, Systolic, Sulaimani
References
[1] C. Chrysohoou, M. Greenberg, C. Pitsavos, D. B. Panagiotakos, V. Ladis, J. Barbetseas, et al., "Diastolic function in young patients with beta-thalassemia major: an echocardiographic study," Echocardiography, vol. 23, pp. 38-44, Jan 2006.
https://doi.org/10.1111/j.1540-8175.2006.00148.x
[2] P. Spirito, G. Lupi, C. Melevendi, and C. Vecchio, "Restrictive diastolic abnormalities identified by Doppler echocardiography in patients with thalassemia major," Circulation, vol. 82, pp. 88-94, 1990.
https://doi.org/10.1161/01.CIR.82.1.88
[3] D. Iarussi, G. Di Salvo, V. Pergola, P. Coppolino, M. A. Tedesco, G. Ratti, et al., "Pulsed Doppler tissue imaging and myocardial function in thalassemia major," Heart and vessels, vol. 18, pp. 1-6, 2003.
https://doi.org/10.1007/s003800300000
[4] R. A. Nishimura and A. J. Tajik, "Evaluation of diastolic filling of left ventricle in health and disease: Doppler echocardiography is the clinician's Rosetta Stone," J Am Coll Cardiol, vol. 30, pp. 8-18, Jul 1997.
https://doi.org/10.1016/S0735-1097(97)00144-7
[5] G. Hahalis, D. Alexopoulos, D. T. Kremastinos, and N. C. Zoumbos, "Heart failure in beta-thalassemia syndromes: a decade of progress," Am J Med, vol. 118, pp. 957-67, Sep 2005.
https://doi.org/10.1016/j.amjmed.2005.02.021
[6] A. Aessopos, S. Deftereos, M. Tsironi, F. Karabatsos, J. Yousef, C. Fragodimitri, et al., "Predictive echo-Doppler indices of left ventricular impairment in B-thalassemic patients," Ann Hematol, vol. 86, pp. 429-34, Jun 2007.
https://doi.org/10.1007/s00277-007-0257-y
[7] C. A. Finch, V. Bellotti, S. Stray, D. A. Lipschitz, J. D. Cook, M. J. Pippard, et al., "Plasma ferritin determination as a diagnostic tool," West J Med, vol. 145, pp. 657-63, Nov 1986.
[8] G. M. Brittenham, A. R. Cohen, C. E. McLaren, M. B. Martin, P. M. Griffith, A. W. Nienhuis, et al., "Hepatic iron stores and plasma ferritin concentration in patients with sickle cell anemia and thalassemia major," Am J Hematol, vol. 42, pp. 81-5, Jan 1993.
https://doi.org/10.1002/ajh.2830420116
[9] J. C. Wood, C. ENRIQUEZ, N. GHUGRE, M. OTTO-DUESSEL, M. AGUILAR, M. D. NELSON, et al., "Physiology and pathophysiology of iron cardiomyopathy in thalassemia," Annals of the New York Academy of Sciences, vol. 1054, p. 386, 2005.
https://doi.org/10.1196/annals.1345.047
[10] H. Yang, A. Woo, D. Monakier, M. Jamorski, K. Fedwick, E. D. Wigle, et al., "Enlarged left atrial volume in hypertrophic cardiomyopathy: a marker for disease severity," J Am Soc Echocardiogr, vol. 18, pp. 1074-82, Oct 2005.
https://doi.org/10.1016/j.echo.2005.06.011
[11] H. D. Allen, D. J. Driscoll, R. E. Shaddy, and T. F. Feltes, Moss & Adams' heart disease in infants, children, and adolescents: including the fetus and young adult: Lippincott Williams & Wilkins, pp. 97-103,2008.
[12] M. Philip, H. Thomas; Assessment of diastolic function: what the general cardiologist needs to know; Heart , pp.681-695., 2005
https://doi.org/10.1136/hrt.2003.029413
[13]. H. Rakowski, et al. Canadian consensus recommendations for the measurement and reporting of diastolic dysfunction by echocardiography: From the Investigators of Consensus on Diastolic Dysfunction by Echocardiography. J Am Soc Echocardiogr ,pp.736-760,1996,
https://doi.org/10.1016/S0894-7317(96)90076-0
[14]. S.F. Nagueh, et al. Doppler estimation of left ventricular filling pressure in sinus tachycardia. A new application of tissue doppler imaging. Circulation .pp.1644-1650, 1998.
https://doi.org/10.1161/01.CIR.98.16.1644
[15]. D.W. Sohn, et al. Assessment of mitral annulus velocity by Doppler tissue imaging in the evaluation of left ventricular diastolic function. J Am Coll Cardiol 1997; pp-474-480.
https://doi.org/10.1016/S0735-1097(97)88335-0
[16]. V. Rajagopalan, et al. Comparison of new Doppler echocardiographic methods to differentiate constrictive pericardial heart disease and restrictive cardiomyopathy. Am J Cardiol 2001;pp-86-94.
https://doi.org/10.1016/S0002-9149(00)01278-9
[17]. Sundereswaran L, et al. Estimation of left and right ventricular filling pressures after heart transplantation by tissue Doppler imaging. Am J Cardiol ,pp.352-357,1998.
https://doi.org/10.1016/S0002-9149(98)00346-4
[18]. Appleton CP, Hatle LK, Popp RL. Demonstration of restrictive ventricular physiology by Doppler echocardiography. J Am Coll Cardiol ,pp.757-768,1988.
https://doi.org/10.1016/0735-1097(88)90208-2
[19]. M.J. Garcia, J.D. Thomas, A.L. Klein. New Doppler echocardiographic applications for the study of dias tolic function, J Am Coll Cardiol , pp.865-875,1998.
https://doi.org/10.1016/S0735-1097(98)00345-3
[20] M. A. ENGLE, M. Erlandson, and C. H. SMITH, "Late cardiac complications of chronic, severe, refractory anemia with hemochromatosis," Circulation, vol. 30, pp. 698-705, 1964.
https://doi.org/10.1161/01.CIR.30.5.698
[21] B. Modell, M. Khan, and M. Darlison, "Survival in beta-thalassaemia major in the UK: data from the UK Thalassaemia Register," Lancet, vol. 355, pp. 2051-2, Jun 10 2000.
https://doi.org/10.1016/S0140-6736(00)02357-6
[22] D. Grisaru, E. A. Rachmilewitz, M. Mosseri, M. Gotsman, J. S. Lafair, E. Okon, et al., "Cardiopulmonary assessment in beta-thalassemia major," Chest, vol. 98, pp. 1138-1142, 1990.
https://doi.org/10.1378/chest.98.5.1138
[23] N. F. Oliveri, D. G. Nathan, J. H. MacMillan, A. S. Wayne, P. P. Liu, A. McGee, et al., "Survival in medically treated patients with homozygous ?-thalassemia," New England Journal of Medicine, vol. 331, pp. 574-578, 1994.
https://doi.org/10.1056/NEJM199409013310903
[24] C. Y. Choong, H. C. Herrmann, A. E. Weyman, and M. A. Fifer, "Preload dependence of Doppler-derived indexes of left ventricular diastolic function in humans," J Am Coll Cardiol, vol. 10, pp. 800-8, Oct 1987.
https://doi.org/10.1016/S0735-1097(87)80273-5
[25] B. Kircher, J. A. Abbott, S. Pau, R. G. Gould, R. B. Himelman, C. B. Higgins, et al., "Left atrial volume determination by biplane two-dimensional echocardiography: validation by cine computed tomography," Am Heart J, vol. 121, pp. 864-71, Mar 1991.
https://doi.org/10.1016/0002-8703(91)90200-2
[26] D. T. Kremastinos, D. P. Tsiapras, G. A. Tsetsos, E. I. Rentoukas, H. P. Vretou, and P. K. Toutouzas, "Left ventricular diastolic Doppler characteristics in beta-thalassemia major," Circulation, vol. 88, pp. 1127-35, Sep 1993.
https://doi.org/10.1161/01.CIR.88.3.1127
[27] A. Aessopos, D. Farmakis, A. Hatziliami, C. Fragodimitri, F. Karabatsos, J. Joussef, et al., "Cardiac status in well?treated patients with thalassemia major," European journal of haematology, vol. 73, pp. 359-366, 2004.
https://doi.org/10.1111/j.1600-0609.2004.00304.x
[28] D. T. Kremastinos, E. Rentoukas, S. Mavrogeni, Z. S. Kyriakides, C. Politis, and P. Toutouzas, "Left ventricular filling pattern in beta-thalassaemia major--a Doppler echocardiographic study," Eur Heart J, vol. 14, pp. 351-7, Mar 1993.
https://doi.org/10.1093/eurheartj/14.3.351
https://doi.org/10.1111/j.1540-8175.2006.00148.x
[2] P. Spirito, G. Lupi, C. Melevendi, and C. Vecchio, "Restrictive diastolic abnormalities identified by Doppler echocardiography in patients with thalassemia major," Circulation, vol. 82, pp. 88-94, 1990.
https://doi.org/10.1161/01.CIR.82.1.88
[3] D. Iarussi, G. Di Salvo, V. Pergola, P. Coppolino, M. A. Tedesco, G. Ratti, et al., "Pulsed Doppler tissue imaging and myocardial function in thalassemia major," Heart and vessels, vol. 18, pp. 1-6, 2003.
https://doi.org/10.1007/s003800300000
[4] R. A. Nishimura and A. J. Tajik, "Evaluation of diastolic filling of left ventricle in health and disease: Doppler echocardiography is the clinician's Rosetta Stone," J Am Coll Cardiol, vol. 30, pp. 8-18, Jul 1997.
https://doi.org/10.1016/S0735-1097(97)00144-7
[5] G. Hahalis, D. Alexopoulos, D. T. Kremastinos, and N. C. Zoumbos, "Heart failure in beta-thalassemia syndromes: a decade of progress," Am J Med, vol. 118, pp. 957-67, Sep 2005.
https://doi.org/10.1016/j.amjmed.2005.02.021
[6] A. Aessopos, S. Deftereos, M. Tsironi, F. Karabatsos, J. Yousef, C. Fragodimitri, et al., "Predictive echo-Doppler indices of left ventricular impairment in B-thalassemic patients," Ann Hematol, vol. 86, pp. 429-34, Jun 2007.
https://doi.org/10.1007/s00277-007-0257-y
[7] C. A. Finch, V. Bellotti, S. Stray, D. A. Lipschitz, J. D. Cook, M. J. Pippard, et al., "Plasma ferritin determination as a diagnostic tool," West J Med, vol. 145, pp. 657-63, Nov 1986.
[8] G. M. Brittenham, A. R. Cohen, C. E. McLaren, M. B. Martin, P. M. Griffith, A. W. Nienhuis, et al., "Hepatic iron stores and plasma ferritin concentration in patients with sickle cell anemia and thalassemia major," Am J Hematol, vol. 42, pp. 81-5, Jan 1993.
https://doi.org/10.1002/ajh.2830420116
[9] J. C. Wood, C. ENRIQUEZ, N. GHUGRE, M. OTTO-DUESSEL, M. AGUILAR, M. D. NELSON, et al., "Physiology and pathophysiology of iron cardiomyopathy in thalassemia," Annals of the New York Academy of Sciences, vol. 1054, p. 386, 2005.
https://doi.org/10.1196/annals.1345.047
[10] H. Yang, A. Woo, D. Monakier, M. Jamorski, K. Fedwick, E. D. Wigle, et al., "Enlarged left atrial volume in hypertrophic cardiomyopathy: a marker for disease severity," J Am Soc Echocardiogr, vol. 18, pp. 1074-82, Oct 2005.
https://doi.org/10.1016/j.echo.2005.06.011
[11] H. D. Allen, D. J. Driscoll, R. E. Shaddy, and T. F. Feltes, Moss & Adams' heart disease in infants, children, and adolescents: including the fetus and young adult: Lippincott Williams & Wilkins, pp. 97-103,2008.
[12] M. Philip, H. Thomas; Assessment of diastolic function: what the general cardiologist needs to know; Heart , pp.681-695., 2005
https://doi.org/10.1136/hrt.2003.029413
[13]. H. Rakowski, et al. Canadian consensus recommendations for the measurement and reporting of diastolic dysfunction by echocardiography: From the Investigators of Consensus on Diastolic Dysfunction by Echocardiography. J Am Soc Echocardiogr ,pp.736-760,1996,
https://doi.org/10.1016/S0894-7317(96)90076-0
[14]. S.F. Nagueh, et al. Doppler estimation of left ventricular filling pressure in sinus tachycardia. A new application of tissue doppler imaging. Circulation .pp.1644-1650, 1998.
https://doi.org/10.1161/01.CIR.98.16.1644
[15]. D.W. Sohn, et al. Assessment of mitral annulus velocity by Doppler tissue imaging in the evaluation of left ventricular diastolic function. J Am Coll Cardiol 1997; pp-474-480.
https://doi.org/10.1016/S0735-1097(97)88335-0
[16]. V. Rajagopalan, et al. Comparison of new Doppler echocardiographic methods to differentiate constrictive pericardial heart disease and restrictive cardiomyopathy. Am J Cardiol 2001;pp-86-94.
https://doi.org/10.1016/S0002-9149(00)01278-9
[17]. Sundereswaran L, et al. Estimation of left and right ventricular filling pressures after heart transplantation by tissue Doppler imaging. Am J Cardiol ,pp.352-357,1998.
https://doi.org/10.1016/S0002-9149(98)00346-4
[18]. Appleton CP, Hatle LK, Popp RL. Demonstration of restrictive ventricular physiology by Doppler echocardiography. J Am Coll Cardiol ,pp.757-768,1988.
https://doi.org/10.1016/0735-1097(88)90208-2
[19]. M.J. Garcia, J.D. Thomas, A.L. Klein. New Doppler echocardiographic applications for the study of dias tolic function, J Am Coll Cardiol , pp.865-875,1998.
https://doi.org/10.1016/S0735-1097(98)00345-3
[20] M. A. ENGLE, M. Erlandson, and C. H. SMITH, "Late cardiac complications of chronic, severe, refractory anemia with hemochromatosis," Circulation, vol. 30, pp. 698-705, 1964.
https://doi.org/10.1161/01.CIR.30.5.698
[21] B. Modell, M. Khan, and M. Darlison, "Survival in beta-thalassaemia major in the UK: data from the UK Thalassaemia Register," Lancet, vol. 355, pp. 2051-2, Jun 10 2000.
https://doi.org/10.1016/S0140-6736(00)02357-6
[22] D. Grisaru, E. A. Rachmilewitz, M. Mosseri, M. Gotsman, J. S. Lafair, E. Okon, et al., "Cardiopulmonary assessment in beta-thalassemia major," Chest, vol. 98, pp. 1138-1142, 1990.
https://doi.org/10.1378/chest.98.5.1138
[23] N. F. Oliveri, D. G. Nathan, J. H. MacMillan, A. S. Wayne, P. P. Liu, A. McGee, et al., "Survival in medically treated patients with homozygous ?-thalassemia," New England Journal of Medicine, vol. 331, pp. 574-578, 1994.
https://doi.org/10.1056/NEJM199409013310903
[24] C. Y. Choong, H. C. Herrmann, A. E. Weyman, and M. A. Fifer, "Preload dependence of Doppler-derived indexes of left ventricular diastolic function in humans," J Am Coll Cardiol, vol. 10, pp. 800-8, Oct 1987.
https://doi.org/10.1016/S0735-1097(87)80273-5
[25] B. Kircher, J. A. Abbott, S. Pau, R. G. Gould, R. B. Himelman, C. B. Higgins, et al., "Left atrial volume determination by biplane two-dimensional echocardiography: validation by cine computed tomography," Am Heart J, vol. 121, pp. 864-71, Mar 1991.
https://doi.org/10.1016/0002-8703(91)90200-2
[26] D. T. Kremastinos, D. P. Tsiapras, G. A. Tsetsos, E. I. Rentoukas, H. P. Vretou, and P. K. Toutouzas, "Left ventricular diastolic Doppler characteristics in beta-thalassemia major," Circulation, vol. 88, pp. 1127-35, Sep 1993.
https://doi.org/10.1161/01.CIR.88.3.1127
[27] A. Aessopos, D. Farmakis, A. Hatziliami, C. Fragodimitri, F. Karabatsos, J. Joussef, et al., "Cardiac status in well?treated patients with thalassemia major," European journal of haematology, vol. 73, pp. 359-366, 2004.
https://doi.org/10.1111/j.1600-0609.2004.00304.x
[28] D. T. Kremastinos, E. Rentoukas, S. Mavrogeni, Z. S. Kyriakides, C. Politis, and P. Toutouzas, "Left ventricular filling pattern in beta-thalassaemia major--a Doppler echocardiographic study," Eur Heart J, vol. 14, pp. 351-7, Mar 1993.
https://doi.org/10.1093/eurheartj/14.3.351
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[1]
A. Faeq Salih and A. M. Hamawandi, “Relation of Left Ventricular Diastolic Dysfunction to Serum Ferritin in Thalassemia Major”, KJAR, vol. 4, no. 3, pp. 224–233, Nov. 2019, doi: 10.24017/science.2019.ICHMS.24.
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17-11-2019
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