بررسي اثر كاپتوپريل در بهبود عملكرد قلب چپ در بيماران مبتلا به بتاتالاسمي ماژور در بيمارستان حضرت علي اصغر(ع) زاهدان در سال 82-81

Evaluation of effect of captopril on left cardiac function in patients with major ^-thalassemia

Objective: Major p-thalassemia is a fatal and severe haemolytic anaemia that causes failure to thrive, body organs dysfunction and iron over load. Cardiac complications are the major cause of death among patients with p-thalassemia major. The purpose of this study was to evaluate the cardiac function in patient with p thalassemia major after treatment with the captopril Subjects and methods: Sixty patients from 110 major p-thalassemic cases, aged between 10 to 21 years, we are selected and underwent this pilot clinical trial. Patients were divided into two groups: before and after receiving captopril or received placebo. Two-D and Doppler echocardiography were taken. The data were statistically analyzed with SPSS soft-ware using studentsʹ t-test and correlation coefficient methods. Results: After treatment with captopril in comparison with the before treatment, the mean Ejection Fraction increased from 54.35% ± 7.7% to 58.74% ± 8.7% (p<0.05), Shortening Fraction increased from 28.12 ±5 to 31.03 ± 6 (p<0.05), Left Ventricular E/A ratio decreased from 1.88± 0.37 to 1.69± 0.41 (p<0.05), PEP/ET in left side decreased from 0.38 ±0.05 to 0.32 ±0.08 (p<0.05), deceleration time of mitral inflow increased from 122 ±24 to 142±32 msec (p<0.05), and LVESD decreased from 3.4 ±0. 5 to 3.1±0.4 (p<0.05). In the control group, after treatment with placebo compared before treatment, mean of EF decreased from 58.73% ±5.3% to 54.63% ± 8% (p<0.05), Shortening Fraction decreased from 31.63 ±4 to 28.6± 5 (P<0.05), deceleration time of mitral inflow increased from 140 ±19 to 192±18 msec (P<0.05). Conclusion: These results showed that captopril is effective in improving the cardiac function in major thalassemic patients. Furthermore, it is also useful in subsets of patients with heart failure, especially in those with restrictive filling pattern.