Role of carotid ultrasound in the evaluation of atherosclerotic changes in beta thalassemia major patients

Abstract

Background: Iron overload in beta thalassemia patients may lead to the alteration of arterial structures together with hyperlipidemia and other risk factors that may lead to the atherosclerotic changes and thickening of carotid arteries. Carotid ultrasound is easy, noninvasive, and rapid test that can detect atherosclerotic changes by the assessment of carotid intima-media thickness, which is a structural marker of atherosclerosis, and it correlates well with vascular risk factors and its relation with stroke and coronary artery disease. Aim: The aim was to evaluate the role of carotid ultrasound in the assessment of atherosclerotic changes in iron-overloaded beta thalassemia major patients. Patients and Methods: This is a case–control study done in Babylon Gynecology and Children Teaching Hospital from July 1 to December 31, 2018 on 60 patients with beta thalassemia major and 30 normal children as a control group. Their age ranges from 3 to 14 years old. Carotid ultrasound examination was done on all patients and the control group. Results: In this study, carotid intima-media thickness was significantly higher in patients than in controls (P < 0.001). Carotid intima-media thickness significantly increases in patients with beta thalassemia major with increasing duration of blood transfusion (P < 0.001), with increasing serum ferritin (P = 0.004), and with increasing serum cholesterol (P < 0.001). The study also showed no correlation between body mass index and blood pressure with carotid intima-media thickness. Conclusion: Carotid ultrasound is useful in the assessment of carotid intima-media thickness, which is a marker of atherosclerosis and has a strong positive correlation with markers of iron overload and hyperlipidemia.

Keywords

• atherosclerotic changes
• beta thalassemia major
• carotid ultrasound