Ashena Zahara, Ghafurian Sorush, Ehsani Mohammad Ali
Bahrami Children Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Pediatr Hematol Oncol. 2007 Jan-Feb;24(1):3-14. doi: 10.1080/08880010600970476.
Iron-induced heart failure is the primary cause of death in thalassemia major patients who receive continuous transfusions. Recent studies have suggested that diastolic function is impaired prior to systolic function in process of hemochromatosis, but they did not come to agreement on the first impaired diastolic index. Additionally, serum ferritin concentration is not a reliable indicator of body iron storage since it increases in any simple inflammation. Accordingly, the authors undertook this study to assess any association between left ventricular diastolic indices and serum ferritin in thalassemic patients with normal systolic function to estimate the true amount of body iron storage and correct it in earlier stages. Serum ferritin concentration and diastolic indices were measured in 29 patients with normal left ventricular systolic function. Linear regression test was used to find any association between hematological and cardiac factors. No significant association was found between diastolic indices and serum ferritin concentration. But the results were quite different in patients above and below 15 years of age; standardized coefficients (r) for peak of E and A were increased in patients above 15, and the significance was close to .05, unlike those of younger group. Although no correlation was found between serum ferritin and diastolic indices, the results were noteworthy in patients above 15. To appropriately judge this relation, the study must be continued with a bigger sample size and having patients' mean serum ferritin concentration during the 2 past years.
铁诱导的心力衰竭是接受持续输血的重型地中海贫血患者的主要死因。最近的研究表明，在血色素沉着症过程中，舒张功能在收缩功能之前就已受损，但对于首个受损的舒张指标尚未达成共识。此外，血清铁蛋白浓度不是体内铁储存的可靠指标，因为在任何简单炎症中它都会升高。因此，作者进行了这项研究，以评估收缩功能正常的地中海贫血患者左心室舒张指标与血清铁蛋白之间的任何关联，从而估计体内铁储存的真实量并在早期阶段进行纠正。对29名左心室收缩功能正常的患者测量了血清铁蛋白浓度和舒张指标。使用线性回归测试来发现血液学和心脏因素之间的任何关联。未发现舒张指标与血清铁蛋白浓度之间存在显著关联。但15岁以上和以下患者的结果差异很大；15岁以上患者E峰和A峰的标准化系数（r）增加，显著性接近0.05，与较年轻组不同。尽管未发现血清铁蛋白与舒张指标之间存在相关性，但15岁以上患者的结果值得注意。为了恰当地判断这种关系，必须以更大的样本量并纳入患者过去两年的平均血清铁蛋白浓度继续进行这项研究。
