Global vasomotor dysfunction and accelerated vascular aging in β-thalassemia major

被引：46

作者：

Hahalis, George ^{[1
]}

Kremastinos, Dimitrios T. ^{[2
]}

Terzis, George ^{[3
]}

Kalogeropoulos, Andreas P. ^{[1
]}

Chrysanthopoulou, Athina ^{[3
]}

Karakantza, Marina ^{[4
]}

Kourakli, Alexandra ^{[4
]}

Adamopoulos, Starnatis ^{[5
]}

Tselepis, Alexandros D. ^{[6
]}

Grapsas, Nikos ^{[7
]}

Siablis, Dimitrios ^{[3
]}

Zournbos, Nicholas C. ^{[4
]}

Alexopoulos, Dimitrios ^{[1
]}

机构：

[1] Univ Hosp Patras, Dept Cardiol, Patras, Greece

[2] Univ Athens, Attiknon Gen Hosp, Dept Cardiol 2, GR-10679 Athens, Greece

[3] Univ Hosp Patras, Dept Radiol, Patras, Greece

[4] Univ Hosp Patras, Dept Hematol, Patras, Greece

[5] Onassis Cardiac Surg Ctr, Dept Cardiol 2, Athens, Greece

[6] Univ Ioannina, Biochem Lab, Dept Chem, GR-45110 Ioannina, Greece

[7] Agios Andreas Hosp, Dept Cardiol 1, Patras, Greece

来源：

ATHEROSCLEROSIS | 2008年 / 198卷 / 02期

关键词：

thalassemia; carotid atherosclerosis; endothelium; iron-overload; inflammation;

D O I：

10.1016/j.atherosclerosis.2007.09.030

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Patients with beta-thalassemia major (beta-TM) demonstrate an increased incidence of vascular complications, which are thought to result from a procoagulant/proinflammatory environment. We investigated the arterial vasorelaxing capacity and sought for early carotid atherosclerosis and underlying pathophysiological correlates in these transfusion-dependent patients. Methods and results: The vasodilatory properties of the brachial artery and the carotid intima-media thickness (IMT) were examined with ultrasonography in 35 non-diabetic young adults with beta-TM (patient group) and 35 control subjects (control group). Among thalassemic patients, both endothelium-dependent (FMD) and -independent dilatation (FID) as well as their ratio was impaired, whereas IMT was increased (p<0.01). Patients on optimal, as compared with those on non-optimal chelation treatment had a non-significantly lower IMT. Vasodilatory capacity in the patient group was inversely correlated with IMT and independently associated either with the quality of chelation therapy (FMD) or serum ferritin levels (FID). Plasma concentrations of D-dimers, circulating markers of endothelial activation, inflammation and apoptosis were higher, while plasma cholesterol and fibrinogen levels were lower-than-normal in the patient group. Independent predictors of IMT among thalassemic patients were tumor necrosis factor-alpha levels and age. Conclusions: Young adults with beta-TM exhibit both a global impairment of arterial vasorelaxation and early carotid atherosclerosis. A procoagulant/proinflammatory state in these transfusion-dependent patients may overwhelm atheroprotective mechanisms, including an optimal chelation regimen, and promote vascular injury and atherogenesis. (C) 2007 Elsevier Ireland Ltd. All rights reserved.

引用

页码：448 / 457

页数：10

共 59 条

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