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- Title
Cardiac mortality in {beta}-thalassemia major: resting but not dobutamine stress echocardiography predicts mortality among initially cardiac disease-free patients in a prospective 12-year study.
- Authors
Hahalis G; Kourakli A; Gerasimidou I; Kalogeropoulos AP; Sitafidis G; Papageorgiou U; Davlouros P; Grapsas N; Zoumbos NC; Alexopoulos D; Hahalis, George; Kourakli, Alexandra; Gerasimidou, Ioanna; Kalogeropoulos, Andreas P; Sitafidis, George; Papageorgiou, Urania; Davlouros, Periklis; Grapsas, Nikos; Zoumbos, Nicholas C; Alexopoulos, Dimitrios
- Abstract
<bold>Aims: </bold>Cardiac death remains the principal cause of mortality in beta-thalassemia major (beta-TM). Echocardiography may provide additional information, incremental to haematological profile, both for guiding chelation therapy and to assess prognosis. <bold>Methods and Results: </bold>Between 1993 and 1995, 36 patients with beta-TM and normal cardiac function and 25 normal volunteers underwent evaluation using resting and dobutamine stress echocardiography (DSE). Dobutamine stress echocardiography was performed at baseline and repeated after 2 years. The primary endpoint was cardiac mortality. During a 12-year observation period, seven patients (19%) died from heart failure. All seven deaths occurred among the cohort of 12 patients with median ferritin concentrations >or= 2800 ng/mg. In addition, a resting left ventricular ejection fraction (LVEF) < 60% was also associated with increased late mortality. In multivariate analysis, increased serum ferritin levels and reduced LVEF but not DSE or other haematological variables were independent survival determinants. <bold>Conclusion: </bold>Resting LVEF provides prognostic information that is additional to ferritin levels among patients with beta-TM.
- Publication
European Journal of Heart Failure, 2009, Vol 11, Issue 12, p1178
- ISSN
1388-9842
- Publication type
journal article
- DOI
10.1093/eurjhf/hfp152