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Left Atrial Contractile Function Is Persistently Augmented in Newly Diagnosed Asymptomatic Hereditary Hemochromatosis Subjects Despite One Year Therapy
Author(s) -
Shizukuda Yukitaka,
Bolan Charles D,
Tripodi Dorothy J,
Sachdev Vandana,
Nguyen Tammy,
Sidenko Stanislav,
Ernst Inez,
Yau Yu Ying,
Botello Gilberto,
Leitman Susan F,
Ali Mir I,
Rosing Douglas R
Publication year - 2007
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.21.6.a1409-b
Subject(s) - asymptomatic , medicine , hereditary hemochromatosis , cardiology , phlebotomy , ejection fraction , population , isovolumic relaxation time , hemochromatosis , doppler echocardiography , diastole , gastroenterology , heart failure , blood pressure , environmental health
We have previously shown that left atrial (LA) contractile function in newly diagnosed asymptomatic hereditary hemochromatosis (HH) subjects with modest iron overload is significantly augmented than control subjects despite the lack of detectable left ventricular (LV) relaxation abnormalities. However, the therapeutic effect of phlebotomy in this population has never been monitored. We monitored LA function and LV diastolic function of this population using 2D and Doppler echocardiography over 12‐month therapy. We recruited 22 newly diagnosed asymptomatic HH subjects ages 48±11 (mean±SD). All HH subjects had HEF C282Y homozygosity and and underwent follow up echocardiography at 6‐month and 12‐month of phlebotomy treatment. The HH subjects showed significantly higher normalized active emptying volume (AEV‐N; 7.5±2.8 vs 5.5±1.9 ml/m2), active emptying fraction (AEF; 41.6±10.0 vs 34.2±10.2%), ejection force (AF; 15.2±5.9 vs 10.3±4.1 kdyne), and kinetic energy (KE; 25.1±15.9 vs 14.0±7.1 kerg) of LA at baseline (data are HH vs controls, P<0.05 for all). Despite the significant reduction of iron overload during 12‐month therapy, no significant changes in the LA contractile function were noted in HH subjects [AEV‐N(ml/m2);8.4±5.6, AEF(%);43.8±13.7, AF(kdyne);14.5±8.3, KE(kerg);28.1±14.8, data are at 12‐month(n=18)]. The indices of LV relaxation were not changed. Our results suggest that augmentation of LA contractile function is persistent in asymptomatic HH subjects despite one year therapy of iron removal. Further investigation is needed to determine the therapeutic effect.