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دانلود مقاله :
Long-term treatment with deferiprone enhances left ventricular ejection function when compared to deferoxamine in patients with thalassemia major 2013
دانلوذ نویسندگان :
Aldo Filosa , Angela Vitrano , Paolo Rigano , Giuseppina Calvaruso , Rita Barone , Marcello Capra ,
Liana Cuccia , Francesco Gagliardotto , Lorella Pitrolo , Luciano Prossomariti , Maddalena Casale ,
Vincenzo Caruso , Calogera Gerardi , Saveria Campisi , Paolo Cianciulli , Michele Rizzo ,
Giuseppe D'Ascola , Angela Ciancio , Aurelio Maggio
فرمت: pdf
چکیده :
Transfusion and iron chelation treatment have significantly reduced morbidity and improved survival of patients
with thalassemia major. However, cardiac disease continues to be the most common cause of death.
We report the left-ventricular ejection fraction, determined by echocardiography, in one hundred sixty-eight
patients with thalassemia major followed for at least 5 years who received continuous monotherapy with
deferoxamine () or deferiprone (). The statistical analysis, using the generalized estimating
equations model, indicated that the group treated with deferiprone had a significantly better left-ventricular
ejection fraction than did those treated with deferoxamine (coefficient 0.97; 95% CI 0.37; 1.6, ).
The heart may be particularly sensitive to iron-induced mitochondrial damage because of the large number of
mitochondria and its low level of antioxidants. Deferiprone, because of its lower molecular weight, might cross
into heart mitochondria more efficiently, improving their activity and, thereby, myocardial cell function.
Our findings indicate that the long-term administration of deferiprone significantly enhances left-ventricular
function over time in comparison with deferoxamine treatment. However, because of limitations related to
the design of this study, these findings should be confirmed in a prospective, randomized clinical trial.
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