الفهرس 
BETA THALASSEMIAOnly 14 pages are availabe for public view
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Abstract
β
thalassemia which is caused by decrease in production of β-globin chains affects multiple organs and is associated with considerable morbidity and mortality.
Heart complications represent the leading cause of mortality in thalassemia major, even though following the introduction of chelating therapies, an important and progressive increase of life expectancy mainly due to reduction in mortality due to cardiac dysfunction has been demonstrated.
Tissue hypoxia is a major stimulus for the up-regulation of VEGF and anemic patients have elevated levels of VEGF. This suggests that anemia might impact on the progression of angeiogenesis in malignant and benign diseases.
The aim of the present analysis is to assess the level of vascular endothelial growth factor (VEGF) as a marker of angiogenesis in patients with β-thalassemia major and to correlate it with echocardiographic finding. As our study was based on a hypothesis that VEGF will be elevated in thalassemic patients and can be used as a marker for early detection of cardiac impairment in thalassmic patients.
The current study is a cross-sectional study that was carried out on 97 subjects. Included subjects divided into two groups Group I: (CaseGroup): includes 47 patients diagnosed with β-thalassemia major were selected from hematology clinic of Ain Shams University hospital. Group II: (Control group): includes 50 control healthy individuals.
Echocardiography was done including pulsed Echo-doppler and serum VEGF levels were measured in patients with β thalassemia major.
Serum VEGF levels were measured in control group.
Results revealed as regarding to the demographic characteristics of patients with thalassemia and control group, no significant differences were found between the two studied groups regarding sex and age.
Upon comparing the serum level of VEGF between thalassemic patients and control group showed there were a highly significant differences between case and control group.
Results also revealed that 53% of studied β thalassemia major patients had diastolic dysfunction i.e. restrictive LV filling as proven by Echo-Doppler (increase in E/A ratio) and there was increase in pulmonary artery pressure ≥ 35 mmHg in about 42.5% of this patients.
There were a significant positive correlation between the VEGF and pulmonary artery pressure.
Upon comparing between the thalassemic patients who underwent splenectomy and those who didn’t.A significant increase in AO diam, LA, IVSs, LVIDd, LVIDs, LVPWs, EDV, ESV, SV.were found in thalassemic patients who underwent splenectomy in comparison to those who didn’t.
Comparison between 3 groups of chelation therapies, a significant increase in VEGF in patients receiving deferoxamine (DFO) compared to those receiving deferasirox (DFX). Also a significant relation was found as regard to AO Diam, being significantly higher in patients receiving deferoxamine in comparison to patients receiving combined therapy.
The study demonstrated a statistically significant positive correlation between the age of patients and AO Diam, LA Diam, IVSs, LVIDd, LVIDs, LVPWd, LVPWs, EDV, ESV and SV.