The vascular endothelium is a dynamic endocrine structure that actively contributes to the maintenance of vascular homeostasis. Endothelial dysfunction, which serves as a marker of vascular damage, often precedes and initiates cardiovascular disease. The identification of endothelial dysfunction holds significant clinical importance and can be achieved through the examination of various cell markers or functional tests.
Endothelial damage leads to arterial stiffness, which aids in the diagnosis of atherosclerosis and cardiovascular diseases, while also acting as a marker for increased cardiovascular morbidity and mortality. Pulse wave velocity measurement is one of the primary methods used to assess arterial stiffness, serving as an independent risk factor for future cardiovascular events and overall mortality.
In patients with beta-thalassemia major (BTM), free iron-related peroxidative tissue damage is associated with a high risk of developing endothelial dysfunction and arterial stiffness. Increased life expectancy and the alarming prevalence of classic cardiovascular risk factors such as diabetes, arterial hypertension, and smoking lead to an increased risk of accelerated atherosclerosis and cardiovascular disease in BTM patients.
Multicenter studies focusing on the evaluation of vascular damage and oxidative stress in BTM patients continue to be conducted in order to enhance early diagnosis, secondary prevention, and timely therapeutic interventions.
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