چكيده لاتين :
Background: Beta-thalassemia major is a severe and lethal
hemolytic anemia. Regular transfusion is necessary for avoidance
of its complications but it may end to cardiac involvement
secondary to iron overload . Angiotensin converting enzyme
inhibitors (ACEIs) are useful medications even in early
stages of heart failure. We studied the effects of two common
ACEIs on improvement of heart function jn asymptomatic
patients with beta thalassemia .
Methods: Of 300 patients over 10 years old with betathalassemia,
62 asymptomatic patients were divided into two
groups, Captopril (I mg/kg/d in 2-3 divided doses) was started
for patients in group one and enalapril (0.1 mg/kg once daily)
was started for patients in group two. Six months later, systolic
and diastolic parameters were assessed and compared
with those before treatment with ACEIs in each group and
after treatment between the two groups.
Results: In group one, left myocardial performance index,
ejection fraction and fractional shortening were improved significantly
(P<0,001). Decrease in peak atrial velocity and increase
in early maximum filling velocity/atrial velocity (E/A)
ratio of mitral valve were also significant (P=0.04 and P=0.01 respectively). In group two, a significant improvement in
myocardial performance index, ejection fraction, and fractional
shortening was seen compared with before treatment
(P<0.001). Also peak early maximum filling velocity of mitral
valve and peak atrial velocity of tricuspid valve were improved.
Comparison of the two groups after treatment with
ACEls did not show any difference, although both of them
showed significant improvement.
Conclusion: In patient with beta-thalassemia major early administration
of ACEls is recommended. Since the difference
between the efficacy of captopril and enalapril was not significant,
both drugs seem to be suitable in these patients.
