Skip Navigation



European Journal of Heart Failure Advance Access published online on November 4, 2009
European Journal of Heart Failure, doi:10.1093/eurjhf/hfp152
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
11/12/1178    most recent
hfp152v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Hahalis, G.
Right arrow Articles by Alexopoulos, D.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Hahalis, G.
Right arrow Articles by Alexopoulos, D.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org.

Cardiac mortality in β-thalassemia major: resting but not dobutamine stress echocardiography predicts mortality among initially cardiac disease-free patients in a prospective 12-year study

George Hahalis1,*, Alexandra Kourakli2, Ioanna Gerasimidou1, Andreas P. Kalogeropoulos1, George Sitafidis1, Urania Papageorgiou3, Periklis Davlouros1, Nikos Grapsas4, Nicholas C. Zoumbos2 and Dimitrios Alexopoulos1

1 Department of Cardiology, Patras University Medical School, 7 Larnakos Street, Rio, Patras 26441, Greece
2 Department of Hematology, Patras University Medical School, Rio, Patras, Greece
3 Department of Hematology, Karamandaneio Hospital, Patras, Greece
4 Department of Cardiology, Agios Andreas Hospital, Patras, Greece

* Corresponding author. Email: ghahalis{at}otenet.gr


  Abstract

Aims: Cardiac death remains the principal cause of mortality in β-thalassemia major (β-TM). Echocardiography may provide additional information, incremental to haematological profile, both for guiding chelation therapy and to assess prognosis.

Methods and results: Between 1993 and 1995, 36 patients with β-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 ≥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.

Conclusion: Resting LVEF provides prognostic information that is additional to ferritin levels among patients with β-TM.

Key Words: Thalassemia • Heart failure • Echocardiography • Mortality

Received May 10, 2009; Revised August 9, 2009; Accepted August 26, 2009


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.