Stiffness of the abdominal aorta in beta-thalassemia major patients related with body iron load.
OBJECTIVE
Increased iron stores have been implicated in the association with increased risk of cardiovascular events. We evaluated whether the abdominal aortic stiffness was altered in the patients with beta-thalassemia major in relation with body iron load.


METHODS
Sixty-two (32 males and 30 females) beta-thalassemia major patients aged 16.47 +/- 4.8 years were enrolled into the study. Healthy 52 subjects matched for age and sex were recruited as controls. In all subjects, hemoglobin, fasting glucose, cholesterol, high-density lipoprotein-cholesterol, and low-density lipoprotein-cholesterol levels were measured. The average serum ferritin level and liver iron concentration (LIC) were assessed in thalassemia patients. Left ventricular function and mass were evaluated echocardiographically and aortic strain (S), pressure strain elastic modulus (Ep), and normalized Ep (Ep*), aortic distensibility (DIS), and beta stiffness index (beta index) were calculated in all subjects.


RESULTS
There was no statistically significant difference between the study and control groups in sex, mean age, body mass index, heart rate, and systolic blood pressure (P > 0.05). However, pulse pressure and left ventricular mass index (LVMI) were found higher in thalassemia major patients compared with the control group. In beta-thalassemia major patients S (0.21 +/- 0.027 vs. 0.26 +/- 0.017, P < 0.0001) and DIS (1.07 +/- 0.25 vs. 1.56 +/- 0.37, P < 0.0001) were significantly lower compared with the control group. However, Ep (196.9 +/- 44.86 vs. 134.20 +/- 29.10, P < 0.0001), Ep* (3.26 +/- 0.98 vs. 2.04 +/- 0.60, P < 0.0001), and beta index (2.44 +/- 0.58 vs. 1.61 +/- 0.37, P < 0.0001) were significantly higher in beta-thalassemia patients than controls. There was a statistically significant negative correlation between LIC and S, DIS. There was also negative correlation between LVMI and S. However, there was a statistically significant positive correlation between LIC and Ep, Ep*.


CONCLUSIONS
Increased abdominal aortic stiffness was detected in beta-thalassemia major patients and this increase in arterial stiffness correlated with LIC and LVMI.
Ulger
Zulal
Z
Department of Pediatric Cardiology, Ege University Hospital, Bornova-Izmir, Turkey. drzulger@hotmail.com
Aydinok
Yesim
Y
Gurses
Dolunay
D
Levent
Erturk
E
Ozyurek
Arif R
AR
D000293:Adolescent; D000328:Adult; D001012:Aorta, Abdominal / Q000503:physiopathology*; D001018:Aortic Diseases / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D001794:Blood Pressure; D002648:Child; D004548:Elasticity; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000150:complications / Q000175:diagnosis*; D007501:Iron / Q000032:analysis / Q000097:blood*; D008099:Liver / Q000737:chemistry / Q000378:metabolism / Q000503:physiopathology; D008297:Male; D011237:Predictive Value of Tests; D012307:Risk Factors; D012680:Sensitivity and Specificity; D017086:beta-Thalassemia / Q000097:blood / Q000150:complications / Q000503:physiopathology*
D007501:Iron