Coronary Microvascular function, Peripheral Endothelial Function and Carotid IMT in beta-thalassemia minor

Abstract

Higher prevalence of cardiovascular disease in Thalassemia patients have been known. Potential mechanisms are enhanced platelet activation, LDL oxidation, macrophage activation, and increased nitric oxide destruction. We have investigated coronary flow reserve (CFR), brachial artery flow mediated dilation (FMD) and Carotid intima-media thickness (IMT) in patients with Beta thalessemia minor (BTM). MethodsForty patients with BTM and 35 healthy control subjects were included. In all subjects CFR, brachial artery FMD, carotid artery IMT were measured. ResultsCFR measurements: Coronary baseline diastolic peak flow velocity (DPFV) of left anterior descending coronary artery (LAD) was significantly higher in the BTM group (23.8±3.9 vs. 22.1±3.0, P=0.04). However, hyperemic DPFV was significantly lower (61.1±13.0 vs. 68.2±14.2, P=0.02), and CFR was significantly lower (2.57±0.46 vs. 3.07±0.48, P<0.0001) in the BTM group than that in the control group.Brachial artery FMD and carotid IMT measurements: Percent FMD measurements were significantly lower in the BTM group than that in the controls (6.22±4.29 vs. 8.10±4.00, P=0.01). Carotid IMT measurements were significantly but slightly higher in the BTM group than that in the controls (0.57±0.07 vs. 0.54±0.04, P=0.04). ConclusionCFR reflecting coronary microvascular function and brachial artery FMD are decreased, and carotid IMT is increased in patients with BTM.