Key result
Children with thalassemia major exhibited significantly higher aortic stiffness index (5.47 vs 5.09, p<0.001) and lower aortic distensibility compared to healthy controls.
Why the study?
Cardiovascular diseases are the most common illness requiring medical care in thalassemia, but aortic stiffness in children with thalassemia major compared with healthy peers required evaluation.
Does thalassemia major affect aortic elasticity and stiffness in asymptomatic children compared to healthy controls?
Case-Control (n=130)
No
Does thalassemia major affect aortic elasticity and stiffness in asymptomatic children compared to healthy controls?
Absolute Event Rate: 5.47% vs 5.09%
p-value: p=<0.001
Children with thalassemia major exhibit increased aortic stiffness and reduced aortic distensibility, suggesting early subclinical vascular changes that may increase cardiovascular risk.
Increased aortic stiffness may indicate early vascular changes in thalassemia major; leaves open prognostic value and need for outcome trials.
Cardiovascular diseases are the most common illness that needs special medical care in thalassemia particularly in children and adolescents. We aimed to compare aortic stiffness in thalassemia major and healthy children. The study included 65 asymptomatic thalassemia major 6 to 19-year–old children without known history of heart disease and 65 age- and sex-matched healthy controls. Arterial stiffness indices determined using two-dimensional (2D) and Doppler echocardiography. Data were analyzed by SPSS 20.0 with 0.05 as significant error. From the study, results showed that systolic (p = 0.009) and diastolic (p < 0.001) blood pressures were higher in controls. Left ventricular mass index (LVMI) was higher in patients (p < 0.001). Aortic stiffness index (p < 0.001), pulse pressure (p < 0.001), and pressure strain elastic modulus (p < 0.001) were higher in patients, while aortic strain (p < 0.002) and aortic distensibility (p < 0.001) were lower significantly. Aortic stiffness index was correlated with diastole aorta (p = 0.005), systole aorta (p < 0.001), and LVMI (p < 0.001). Strain was correlated with diastole aorta (p < 0.001). Pulse pressure was correlated with systolic blood pressure (p < 0.001), diastolic blood pressure (p = 0.002) significantly. Aortic distensibility was correlated with systolic blood pressure (p = 0.039) and diastole aorta (p < 0.001) significantly. The pressure strain elastic modulus was correlated only with diastole aorta (p = 0.029). Concluded, aortic stiffness index, pulse pressure, and pressure strain elastic modulus were higher in thalassemia children, while aortic strain and aortic distensibility were lower. This increase may result in reduction of mechanical efficiency of the heart. Therefore, assessment of aortic elastic properties as nontraditional cardiovascular risk factors may contribute to the identification of cardiovascular risks in children with thalassemia
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Noori et al. (2020) conducted a case-control in Thalassemia Major (n=130). Thalassemia major vs. Healthy controls was evaluated on Aortic stiffness index (p=<0.001). Children with thalassemia major exhibited significantly higher aortic stiffness index (5.47 vs 5.09, p<0.001) and lower aortic distensibility compared to healthy controls.
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