Changes in early and late diastolic filling pattern in patients with B-thalassemia major before and after captopril therapy

ABSTRACT

Diastolic left ventricular function has been assessed by echo- Doppler examination in 23 patients [mean age = 11.6 years] with B- thalassemia major. The results were compared with those obtained from 10 normal age-matched control individuals. Parameters showed statistically significant difference between patients and controls were peak flow velocity in late diastole [A], ratio of peak flow velocity in early to late diastole [E/A], isovolumic relaxation time [IVRT], left atrial [LA] and aortic root [Ao] dimensions, left ventricular posterior wall thickness in diastole [LPWdiast], interventricular septal thickness [IVS], left ventricular end diastolic [LVEDD] and end systolic [LVESD] dimensions. Captopril [Capoten], an angiotensin converting enzyme inhibitor, was given to these patients in the therapeutic dose [0.5-1 mg/kg body weight/24 hours]. A follow up study was done for 15 patients after 10-30 days [intermediate study]. The effect of captopril appeared in the form of decrease of A wave with an increase of E/A ratio, which probably suggest improved myocardial diastolic function. Furthermore, left ventricular end diastolic dimension displayed statistically significant decrease