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Iron alone causes diastolic dysfunction

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General fitness, health and nutrition
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16 June 2007
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  1. Eur J Heart Fail. 2007 May;9(5):531-6. Epub 2007 Feb 21. Related
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    NT-proBNP levels and diastolic dysfunction in beta-thalassaemia major
    patients.

    Kremastinos DT, Tsiapras DP, Kostopoulou AG, Hamodraka ES,
    Chaidaroglou AS, Kapsali ED.

    2nd University Department of Cardiology, Attikon General Hospital,
    Athens, Greece.

    BACKGROUND: The early diagnosis and treatment of heart failure in beta-
    thalassaemic patients is related to survival. Iron alone or in
    combination with other factors causes diastolic dysfunction, which
    usually precedes systolic dysfunction. NT-proBNP is a sensitive
    biomarker of ventricular dysfunction. AIM: To evaluate NT-proBNP in
    non heart failure beta-thalassaemic patients. METHODS: Fifty-two beta-
    thalassaemia major patients (mean age: 27.2+/-12.5 years) with normal
    LV systolic function, underwent NT-proBNP measurement and a thorough
    Doppler-echocardiographic and pulsed tissue-Doppler study, 4 days
    following blood transfusion. Fifty-two age matched healthy controls
    were also studied. RESULTS: NT-proBNP and E/E' ratio were increased in
    thalassaemic patients compared with controls [(469+/-171 vs 262+/-51
    pmol/l, p<0.001) and (10.8+/-4.0 vs 6.6+/-1.1, p<0.001)] and were well
    correlated (r: 0.54, p<0.01). Although NT-proBNP levels were increased
    in patients with higher E/E' ratios (E/E' <8: 354+/-119, 8-15:
    516+/-177, >15: 565+/-114 pmol/l, ANOVA p: 0.002) this increase only
    became statistically significant in the 3rd decade of life, while E/E'
    ratio increased in the 4th decade. CONCLUSION: NT-proBNP increases in
    beta-thalassaemia major patients and is related to age and LV
    diastolic dysfunction. NT-proBNP appears to be an early biomarker of
    LV diastolic dysfunction, compared with the conventional Echo-Doppler
    indexes.

    PMID: 17317307 [PubMed - in process]

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