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Changes in left ventricular diastolic function of asymptomatic hereditary hemochromatosis subjects during five years

Yukitaka Shizukuda1, Dorothy J Tripodi, Vandana Sachdev

  • 1Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA. shizukya@uc.edu

The American Journal of Cardiology
|September 20, 2011
PubMed

Insights

Cardiac asymptomatic hereditary hemochromatosis (HH) patients show stable left ventricular (LV) diastolic function over five years with phlebotomy. This study confirms no significant decline in LV diastolic function for HH patients undergoing treatment.

Area of Science:

  • Cardiology
  • Hematology
  • Genetics

Background:

  • Previous studies indicated preserved left ventricular (LV) diastolic function in asymptomatic hereditary hemochromatosis (HH) patients, despite augmented left atrial function.
  • Concerns remain regarding potential progressive LV diastolic dysfunction in HH patients despite conventional phlebotomy treatment.

Purpose of the Study:

  • To prospectively monitor and assess the long-term (5-year) impact of conventional phlebotomy on LV diastolic function in cardiac asymptomatic hereditary hemochromatosis (HH) patients.

Main Methods:

  • Prospective 5-year follow-up study involving 14 newly diagnosed HH, 20 chronic HH, and 18 volunteer control (VC) subjects.
  • Evaluation of LV diastolic function using tissue Doppler imaging and strain rate analysis with color-coded tissue Doppler at baseline and 5-year follow-up.
  • All HH patients were C282Y homozygotes, New York Heart Association functional class I, and received conventional phlebotomy.

Main Results:

  • No statistically significant differences in LV diastolic function measures were observed among the HH and VC groups at the 5-year follow-up.
  • Echocardiographic measures of active left atrial contraction showed a tendency to decrease in HH groups over the 5-year period compared to baseline.
  • LV diastolic function remained comparable across all groups after 5 years, irrespective of HH diagnosis or treatment history.

Conclusions:

  • Conventional phlebotomy treatment appears effective in maintaining stable left ventricular diastolic function in cardiac asymptomatic hereditary hemochromatosis patients over a 5-year period.
  • The study provides reassurance that LV diastolic function does not significantly deteriorate in this patient population under standard care.

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