Key result
Combined chelation therapy with deferiprone and deferoxamine improved left ventricular ejection fraction compared to monotherapy, but did not significantly change diastolic function indexes.
Why the study?
Does combined chelation therapy with deferiprone and deferoxamine improve left ventricular diastolic function and LVEF in adult beta-thalassemia major patients compared to deferoxamine monotherapy?
Observational (n=75)
Does combined chelation therapy with deferiprone and deferoxamine improve left ventricular diastolic function and LVEF in adult beta-thalassemia major patients compared to deferoxamine monotherapy?
Combined chelation therapy with deferiprone and deferoxamine improves LVEF but not diastolic function in asymptomatic beta-thalassemia major patients.
Answers are grounded in this paper and cite their sources.
May extend LVEF benefit of combined chelation in thalassemia; leaves open diastolic effects and needs RCTs before practice change.
Beta-thalassemia major (beta-TM), patients, asymptomatic and with preserved left ventricular ejection fraction (LVEF) were studied echocardiographically. Group A (26 patients), on deferiprone (L1) and deferoxamine (DFO) combination therapy (L1: 80 +/- 27 mg/kg/day, DFO: 160 +/- 87 mg/kg/week) and group B (35 patients) on DFO monotherapy (240 +/- 40 mg/kg/week) for the last 2 years were compared. Another group, C (14 patients), switched to L1 (74 +/- 15 mg/kg/day) plus DFO (158 +/- 48 mg/kg/week) for 20-30 months, was prospectively studied for 2 years. In group A, MRI T2* values were increased and improved in group C during follow-up. The LVEF was better in group A than in group B, while such an improvement was also detected in the group C follow-up study. The Tissue Doppler study E' velocity and E/E' ratio was not different. Similarly, in the group C follow-up no significant change in E/E' ratio was detected. It seems that although LVEF significantly improves with combined therapy, diastolic function indexes do not show a similar change.
No takes yet. Share an insight, caveat, or question.
Tsiapras et al. (2010) conducted an observational in Beta-thalassemia major (n=75). Combined chelation therapy with deferiprone and deferoxamine vs. Deferoxamine monotherapy was evaluated on Left ventricular diastolic function (E' velocity and E/E' ratio) and left ventricular ejection fraction. Combined chelation therapy with deferiprone and deferoxamine improved left ventricular ejection fraction compared to monotherapy, but did not significantly change diastolic function indexes.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: