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Aortic elasticity changes in thalassemia due to heart and liver iron deposition
Noor Mohammad Noori1, Alireza Teimouri2
1Children and Adolescents Health research center, Research Institute of cellular and Molecular Science in Infectious Diseases , Zahedan University of Medical Sciences, Zahedan, Iran.
Insights
Iron overload in children with thalassemia significantly impacts aortic elasticity and heart function. Elevated ferritin levels correlate with heart iron deposition, highlighting the need for advanced imaging like MRI T2*.
Area of Science:
- Cardiology
- Pediatrics
- Radiology
Background:
- Iron overload is a significant complication in thalassemia patients, leading to heart impairment.
- This study investigates changes in aortic elasticity in children with thalassemia due to iron deposition.
Purpose of the Study:
- To assess the impact of iron overload on aortic elasticity in children with thalassemia.
- To correlate ferritin levels with cardiac and liver iron deposition.
Main Methods:
- A case-control study involving 160 thalassemia patients and 80 healthy controls.
- Echocardiography and MRI T2* were used to measure cardiac and liver iron deposition and aortic elasticity parameters.
- Statistical analysis was performed using SPSS, with p < 0.05 considered significant.
Main Results:
- Thalassemia patients showed significant changes in diastolic blood pressure, aortic dimensions, ferritin levels, aortic strain, aortic distensibility, pressure strain elastic modulus, and aortic stiffness β index compared to controls.
- Aortic diameter (AoD), aortic systolic diameter (AoS), ferritin, aortic strain (AS), and aortic distensibility (AD) were increased in thalassemia patients.
- Ferritin levels were significantly higher in thalassemia patients with abnormal heart iron deposition.
Conclusions:
- Aortic dimensions and elasticity parameters are altered in children with thalassemia due to iron overload.
- Ferritin levels are indicative of heart iron deposition but not liver iron deposition in these patients.
- MRI T2* is recommended for evaluating cardiac and liver function in thalassemia patients.
Background:
Iron overload is connected with an expanded prevalence of thalassemia due to heart impairment. This considers pointing to survey changes in thalassemia's aortic elasticity due to iron deposition in the heart and liver of children.
Methods:
This case-control study was performed on 80 healthy and 160 thalassemia patients. The subjects gathered from educational pediatric hospital of Ali Asghar in Zahedan, Iran, from 2019 to 2021. Echocardiography parameters were measured. Ferritin, lipids profile, cardiac and liver MRI T2 * measured in patients only. Aortic elasticity parameters were aortic strain, aortic stiffness β index, aortic distensibility and pressure strain elastic modulus. Data analyzed by SPSS,p< 0.05 was considered as significant.
Results:
Diastolic blood pressure (p<0.001), aortic diameter in diastole (p<0.001), aortic diameter in systole (p<0.001), ferritin (p<0.001), aortic strain (p<0.001), aortic distensibility(p<0.001), pressure strain elastic modulus (p<0.001) and aortic stiffness β index (p<0.001) were changed significantly in thalassemia patients compared to controls. From these variables, AoD, AoS, ferritin, AS and AD increased in thalassemia. Ferritin was higher in thalassemia patients with abnormal heart iron deposition (2131.89±1992.74 v.s 4887.66±3122.59 ng/ml). Considering the level of liver iron deposition, ferritin did not change in patients. Our highlighted variables did not change in patients based on the groups of ferritin.
Conclusion:
Concluded that AoD, AoS, ferritin, AS and AD increased in thalassemia patients. Ferritin increased in thalassemia with abnormal iron overload in the heart but did not change in the liver. Recommended MRI T2* to evaluate dynamic functions of liver and heart in thalassemia patients.
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