Cerebral hemodynamic in patients with major β-Thalassemia using transcranial Doppler sonography

Abstract

Background: β-thalassemia, a severe form of anemia, is an inherited blood disorder characterized by growth retardation, splenomegaly, and bone abnormalities. Complications related to treatment-induced iron overload also affect the quality of life of patients with major β-thalassemia. Some recent studies indicated cerebral hemodynamic disorders and increased risk of stroke in these patients. The aim of this study was to evaluate mean flow velocity (MFV) in some cerebral arteries of patients with major thalassemia using transcranial Doppler ultrasonography.  Materials and Methods: In this cross-sectional study, 26 patients with major thalassemia were investigated. The definitive diagnosis was based on serum hemoglobin electrophoresis. Transcranial Doppler ultrasonography was performed in patients and MFV of internal carotid, anterior cerebral, and middle cerebral. Posterior cerebral arteries were measured. Demographic characteristics, duration of treatment, number of blood transfusions per month, the interval between the last blood transfusion, and the ultrasonography were recorded and analyzed statistically. Results: Ten female and 16 male patients participated in this study. Results showed that 57.7% of patients had a hemodynamic abnormality in at least one vessel. The abnormality was significantly higher in the anterior and middle cerebral arteries (p<0.001 and p=0.005, respectively). Among the variables evaluated, age was significantly associated with hemodynamic dysfunction. This relationship remained significant after using the logistic regression analysis (p=0.0267). Conclusions: Some patients with major thalassemia have a cerebral hemodynamic abnormality. Aging is associated with the higher frequency of this abnormality.