Radial artery wall alterations in genetic hemochromatosis before and afteriron depletion therapy

Iron overload is believed to have an adverse influence on the cardiovascula r system and animal studies have shown that iron may be involved in the eve nts that lead to atherosclerosis via an enhancement of smooth muscle cell p roliferation, lipid oxidation, and free radical production. There are no da ta on the effect of iron overload on arterial structural and mechanical pro perties in humans. We measured wall thickness and distensibility (D) by ult rasonography of the radial artery in 12 patients with uncomplicated genetic hemochromatosis (GH) who were normotensive and without atherosclerotic pla ques. Twelve age- and sex-matched patients were taken as controls. Nine pat ients were evaluated also after iron depletion. Wall thickness was greater in patients with GH than in controls (4-50%, P < .01) whereas D was slightl y reduced in the former group compared with the latter group, though the di fference was not statistically significant. After iron depletion, a signifi cant reduction of wall thickness and a significant increase in D were obser ved (-24% and +33%, P < .05 for both). Thus, in patients with hemochromatos is, arterial wall thickness is increased before the onset of cardiovascular complications. This alteration is reverted by iron depletion, which also c an improve the initial and modest radial artery wall stiffening associated with this condition. Thus, functional and structural alterations in midsize muscle arteries may be an early abnormality of hemochromatosis.