Comparison of Captopril with Enalapril on Improvement of Systolic and Diastolic Heart Functions in Asymptomatic Patients Over 10 Years Old with BetaThalassemia Major

Background: beta-thalassemia major is a severe and lethalhemolytic anemia. regular transfusion is necessary for avoidanceof its complications but it may end to cardiac involvementsecondary to iron overload . angiotensin converting enzymeinhibitors (aceis) are useful medications even in earlystages of heart failure. we studied the effects of two commonaceis on improvement of heart function jn asymptomaticpatients with beta thalassemia .methods: of 300 patients over 10 years old with betathalassemia,62 asymptomatic patients were divided into twogroups, captopril (i mg/kg/d in 2-3 divided doses) was startedfor patients in group one and enalapril (0.1 mg/kg once daily)was started for patients in group two. six months later, systolicand diastolic parameters were assessed and comparedwith those before treatment with aceis in each group andafter treatment between the two groups.results: in group one, left myocardial performance index,ejection fraction and fractional shortening were improved significantly(p<0,001). decrease in peak atrial velocity and increasein early maximum filling velocity/atrial velocity (e/a)ratio of mitral valve were also significant (p=0.04 and p=0.01 respectively). in group two, a significant improvement inmyocardial performance index, ejection fraction, and fractionalshortening was seen compared with before treatment(p<0.001). also peak early maximum filling velocity of mitralvalve and peak atrial velocity of tricuspid valve were improved.comparison of the two groups after treatment withacels did not show any difference, although both of themshowed significant improvement.conclusion: in patient with beta-thalassemia major early administrationof acels is recommended. since the differencebetween the efficacy of captopril and enalapril was not significant,both drugs seem to be suitable in these patients.