Evaluation of the relationship between hepatic and cardiac iron overload with MRI T2* and carotid intima media thickness with Doppler ultrasound in beta thalassemia major patients

2020 ◽  
Author(s):  
Reihaneh Mortazavi Ardestani ◽  
Masoud M. Ardestani
Keyword(s):  
Carotid Artery ◽  
Iron Overload ◽  
Doppler Ultrasound ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Beta Thalassemia ◽  
Control Group ◽  
Cardiac Iron ◽  
Cardiac Iron Overload ◽  
The Relationship

Background: Iron overload is caused early progression of atherosclerosis in beta thalassemia patients due to regular repeated blood transfusion. MRI T2* is a gold standard non-invasive method for detecting hepatic and cardiac iron overload. The aim of this study was the comparison of carotid intima media thickness (CIMT) in the patients and healthy control groups with Doppler ultrasound for early diagnosis of atherogenesis. Another purpose was to assess the relationship between CIMT and iron overload among patients. Materials and methods: This cross-sectional study was performed on twenty patients referred to the Sarvar clinic and twenty age- and sex-matched control group. The CIMT was measured with Color Doppler ultrasound in both groups. Then, MRI T2* results, demographic, and therapeutic information were extracted from their documents. Results: CIMT was insignificantly higher in the patients compared to the control group. For example, it was 0.49 ± 0.05 vs. 0.45 ± 0.03 (p = 0.009) for the right common carotid artery (RCCA) and 0.48 ± 0.06 vs. 0.46 ± 0.04 (p = 0.17) for the left common carotid artery (LCCA). There was no strong relationship between CIMT and age (p = 0.09 for RCCA, p = 0.00 for LCCA), sex, chelation type (for example, p = 0.51 for RCCA with Desferal and p = 0.91 for LCCA with Desferal), age at diagnosis, age at the beginning on transfusion (p = 0.49 for RCCA, p = 0.20 for LCCA), age at the start of chelator (p = 0.74 for RCCA, p = 0.78 for LCCA), and hepatic and cardiac iron overload. Conclusion: Preventive and curative methods should be planned to cease its progression. Furthermore, early initiation of chelator drugs with better efficacy and compliance may reverse the hepatotoxic and adverse myocardial effects of excessive iron.

Application of the Measurement of Carotid Intima-Media Thickness for Prediction of the Essential Hypertension in Children

2018 ◽  
Vol 69 (6) ◽  
pp. 1550-1553
Author(s):  
Rosana Manea ◽  
Bianca Elena Popovici ◽  
Carmen Daniela Neculoiu ◽  
Dan Minea ◽  
Alina Calin
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Carotid Artery ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Diagnostic Methods ◽  
Control Group ◽  
Study Group ◽  
Media Thickness ◽  
Hypertension In Children

Hypertension is a major risk factor for progression of the atherosclerotic process and for developing of degenerative cardiovascular diseases in adulthood. The aim of this study is to evaluate how the measurement of carotid intima - media thickness for prediction of essential hypertension in children can be used.The study group included 81 children and the control group 61 children, all aged between 5 - 17 years and 11 months old, and admitted in Children Hospital Brasov in the period of 2009 � 2014. The study protocol included: BMI, blood pressure and Doppler echography of the common carotid artery for each group. Mean age of the patients from the study group was 13.67 years, 43.20 % girls and 56.80 % boys, while in the control group, the mean age was 14.07 years, 54.10% girls and 45.90 % boys. 70.37% of the children from the study group presented obesity, while in the control group 40.98% were obese. The IMTC study group ranged from 0.52 - 0.69 mm and the limits of the normotensive subjects were 0.32 -0.54 mm. In both groups the obese patients were found to have increased carotid artery intima-media, which means that IMTC was positively correlated with BMI (p=0.000001).It is necessary to identify diagnostic methods easily applicable for children, allowing involvement of the characteristics of the arterial wall in the degenerative pathological processes. Increased intima-media ratio is positively correlated with high values of blood pressure.

scholarly journals Early detection of premature atherosclerosis in β-thalassemia patients by measuring carotid intima-media thickness

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
W E Ibrahim ◽  
O I Youssef ◽  
H G A Ali ◽  
D M A Alnagar
Keyword(s):  
Carotid Artery ◽  
Early Detection ◽  
Iron Overload ◽  
Lipid Profile ◽  
Intima Media Thickness ◽  
Thalassemia Major ◽  
Beta Thalassemia ◽  
Thalassemia Intermedia ◽  
Premature Atherosclerosis ◽  
Media Thickness

Abstract Background Beta-thalassemia patients still suffer from many complications. Transfused patients may develop complications related to iron overload including growth retardation and failure or delay of sexual maturation, cardiac involvement (dilated cardiomyopathy or rarely arrhythmia), liver (fibrosis and cirrhosis), endocrine glands (diabetes mellitus, hypogonadism, insufficiency of parathyroid, thyroid, pituitary and less commonly, adrenal glands). Purpose The present study was undertaken to evaluate the role of Carotid artery intima media thickness (CIMT) measurement as an early detector of premature atherosclerosis in beta-thalassemia children and early adolescents and its relation to biochemical risk factors as iron overload and lipid profile. Patients and Method Twenty-two β-thalassemia major (TM), 8 β-thalassemia intermedia (TI) with confirmed diagnosis of beta-thalassemia (major and intermedia) proved by clinical and laboratory investigations, frequent blood transfusion, chelation therapy with their age ranging from 10 to18 years old and 30 age-and sex matched healthy controls were included. Lipid profile (by colorimetric assay), serum ferritin, and CIMT measurements using high-resolution B-mode ultrasonography were estimated. Results CIMT of thalassemic patients (major and intermedia) was highly significantly increased compared to controls with no significant difference between β-thalassemia major and β thalassemia intermedia groups could be detected. CIMT was positively correlated with serum ferritin, TG, Total cholesterol level in both diseased groups and LDL level in B-TM group only. This provides a good evidence of the presence of premature atherosclerosis in vascular-free TM and TI patients and its relation to increased body iron and dyslipidemia. Conclusion Carotid artery intima media thickness represented a simple, accurate and non-invasive method for early detection of premature atherosclerosis which started early in β- thalassemia patients This study identified a relationship between body iron status, dyslipidemia and increased carotid IMT..

Parathyroid Hormone and Ischemic Cerebrovascular Event

2019 ◽  
Vol 19 (8) ◽  
pp. 1134-1140 ◽  
Author(s):  
Hakan Altay ◽  
Cihan Altın ◽  
Ali Coner ◽  
Haldun Muderrisoglu ◽  
Semih Giray
Keyword(s):  
Parathyroid Hormone ◽  
Intima Media Thickness ◽  
Aortic Distensibility ◽  
Carotid Intima Media Thickness ◽  
Left Ventricular ◽  
Control Group ◽  
Cerebrovascular Event ◽  
Artery Disease ◽  
Relationship Of ◽  
The Relationship

Background: Increased parathyroid hormone (PTH) level is associated with coronary artery disease, hypertension and left ventricular hypertrophy which are all predisposing factors for the ischemic cerebrovascular event (ICVE). Carotid intima-media thickness (CIMT) and aortic distensibility are the two early, subclinical predictors of atherosclerosis. The relation of PTH with CIMT and aortic distensibility in patients with ICVE has not been previously studied. Objective: Our aim was to study the relationship of PTH levels with aortic distensibility and CIMT in patients with ICVE. Methods: Sixty-four ICVE patients and 50 control group were enrolled in the study. PTH levels, aortic distensibility and CIMT were measured in all individuals. Results: PTH levels were significantly higher in ICVE patients than in the controls (60.1±21.6 vs. 52.3±6.2 pg/ml) (p=0. 008). PTH levels were found to be inversely correlated with aortic distensibility (r= -0. 420, p=0.001) and positively correlated with CIMT (r:0, 285, p=0,002). Conclusion: The present study shows that PTH levels are increased in patients with acute ischemic cerebrovascular event compared to the control group. It also demonstrates that PTH levels are inversely related to aortic distensibility of ascending aorta and positively associated with CIMT.

GlutathioneS-transferase gene polymorphism: Relation to cardiac iron overload in Egyptian patients with Beta Thalassemia Major

Hematology ◽  
2015 ◽  
Vol 21 (1) ◽  
pp. 46-53 ◽  
Author(s):  
Galila M. Mokhtar ◽  
Eman M. Sherif ◽  
Nevin M. Habeeb ◽  
Abeer A. Abdelmaksoud ◽  
Eman A. El-Ghoroury ◽  
...  
Keyword(s):  
Gene Polymorphism ◽  
Iron Overload ◽  
Thalassemia Major ◽  
Beta Thalassemia ◽  
Cardiac Iron ◽  
Beta Thalassemia Major ◽  
Transferase Gene ◽  
Egyptian Patients ◽  
Cardiac Iron Overload

scholarly journals Carotid Artery Temperature Reduction with Statin Therapy in Patients with Familial Hyperlipidemia Syndromes

2021 ◽  
Vol 10 (21) ◽  
pp. 5008
Author(s):  
Georgios Benetos ◽  
Spyros Galanakos ◽  
Iosif Koutagiar ◽  
Ioannis Skoumas ◽  
Georgios Oikonomou ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Statin Therapy ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Control Group ◽  
Familial Combined Hyperlipidemia ◽  
Non Invasive ◽  
The Impact ◽  
Familial Hyperlipidemia ◽  
Maximum Minimum

Background: Microwave radiometry (MWR) assesses non-invasive carotid artery temperatures reflecting inflammation. In the present study, we aimed to investigate the impact of hypolipidemic therapy either with simvastatin or with combination simvastatin plus ezetimibe on carotid artery temperatures of patients with familial hyperlipidemia syndromes (FHS). Methods: Consecutive patients with diagnosis of either familial heterozygous hypercholesterolemia (heFH) or familial combined hyperlipidemia (FCH) were included in the study. Patients were assigned to either simvastatin 40 mg or simvastatin 40 mg plus ezetimibe 10 mg, according to the discretion of the physician. FHS patients who refused statin therapy were used as a control group. Common carotid intima-media thickness (ccIMT) was measured and ΔΤ (maximum-minimum) temperature measurements were performed across each carotid during MWR evaluation. RESULTS: In total, 115 patients were included in the study. Of them, 40 patients received simvastatin (19 heFH and 21 FCH), 41 simvastatin + ezetimibe (31 heFH and 10 FCH), and 34 (21 heFH and 13 FCH) no statin. Carotid artery temperatures were significantly reduced at 6 months in FH patients who received hypolipidemic treatment (0.83 ± 0.34 versus 0.63 ± 0.24 oC, p = 0.004 for simvastatin, 1.00 ± 0.38 versus 0.69 ± 0.23 oC, p < 0.001 for simvastatin+ezetimibe), but no change was recorded in controls (0.72 ± 0.26 versus 0.70 ± 0.26 oC, p = 0.86). CONCLUSIONS: Hypolipidemic therapy reduced carotid temperatures in FHS patients.

Assessment of the Relationship Between Iron Overload Based on Cardiac T2* MRI and Fragmented QRS in Beta-Thalassemia Major Patients

2020 ◽  
Vol 21 (8) ◽  
Author(s):  
Yazdan Ghandi ◽  
Danial Habibi ◽  
Aziz Eghbali
Keyword(s):  
Iron Overload ◽  
Chelation Therapy ◽  
Thalassemia Major ◽  
Beta Thalassemia ◽  
Cardiac Iron ◽  
Fragmented Qrs ◽  
Beta Thalassemia Major ◽  
Cardiac Iron Overload ◽  
The Mean ◽  
T2 Mri

Background: Cardiac involvement in beta-thalassemia major patients is an important cause of mortality. Therefore, in these patients, timely diagnosis of cardiac disorder is essential. Objectives: The present study aimed at determining the association between cardiac iron overload and fragmented QRS (fQRS). Methods: This cross-sectional study was conducted on 40 β-TM patients, aged 5 - 40 years. The presence of fQRS was evaluated in 12-lead surface electrocardiograms. Cardiac T2* MRI was performed to determine the iron overload. The patients were divided into four groups of chelation therapy. Results: The mean age of patients was reported to be 22.50 ± 6.75 years. The groups showed no significant difference regarding gender, age, or left ventricular ejection fraction. The presence of fQRS was detected in 10 patients (25%), while T2* value was lower than 20 ms in 10 patients (25%). The mean age of patients with and without fQRS was 26.23 ± 2.71 and 19.40 ± 2.61 years, respectively (P = 0.001). The univariate analysis indicated that fQRS had a significant relationship with cardiac iron overload (OR = 5; 95% CI: 1.04 - 23.99; P < 0.044). The multiple logistic regression analysis represented a significant association between iron overload and fQRS (OR = 5.556; 95% CI: 1.027 - 30.049). The sensitivity and specificity of the fQRS against MRI were equal to 50% and 83.3% respectively. Conclusions: The absence of fQRS on ECGs could be a good predictor of the lack of cardiac iron overload in β-TM patients. The results showed that fQRS might indicate the no need for close monitoring for cardiac overload with cardiac MRI and aggressive chelation therapy.

scholarly journals Low 25-hydroxyvitamin D level increases carotid intima-media thickness in elderly women

2019 ◽  
Vol 38 (2) ◽  
pp. 114
Author(s):  
Yudhisman Imran ◽  
Andini Aswar ◽  
Irmiya Rachmiyani ◽  
Donna Adriani
Keyword(s):  
Vitamin D ◽  
Regression Analysis ◽  
Endothelial Dysfunction ◽  
Carotid Artery ◽  
Elderly Women ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D ◽  
The Relationship

Background<br />Cerebrovascular disease occurs due to atherosclerosis of the carotid artery triggered by endothelial dysfunction, which can be assessed by measuring the carotid intima-media thickness (CIMT). There are several risk factors contributing to endothelial dysfunction, such as 25-hydroxyvitamin D [25(OH)D] deficiency. A number of research studies have shown variable results on the relationship between 25(OH)D deficiency and endothelial dysfunction. The objective of the present study was to determine the relationship between 25(OH)D and CIMT in elderly women.<br /><br />METHODS <br />A cross-sectional study was conducted involving 45 elderly women aged ≥60 years. The inclusion criteria were: able to communicate well and able to walk actively without any help. The exclusion criteria were: not having diabetes mellitus, stroke, heart disease, kidney disease, not consuming vitamin D or medicines containing corticosteroids, and not using hormone replacement therapy. Laboratory examination was conducted for fasting blood sugar, lipid profile, and 25(OH)D. CIMT was measured using carotid Doppler ultrasonography at the left carotid artery. Simple linear regression analysis was used to analyze the data.<br /><br />RESULTS<br />Mean 25(OH)D level was 11.753 ± 4.027 ng/mL, and mean CIMT 0.61 ± 0.10 mm. Simple regression analysis showed a significant relationship between 25(OH)D level and CIMT (β=-0.001; 95% C.I.=-0.020-0.003; p=0.009).<br /><br />CONCLUSION <br />Our data suggest an inverse association between 25(OH)D level and CIMT in elderly women. This study supports the protective role of vitamin D against subclinical atherosclerosis in elderly women.

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