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Myocardial perfusion in children with sickle cell anaemia
P Acar1, S Sébahoun, L de Pontual
1Service de Cardiologie Pédiatrique, Hôpital Necker-Enfants Malades, Paris, France.
Insights
Thallium-201 SPECT detected abnormal myocardial perfusion in children with sickle cell anaemia (SCA), even when asymptomatic. Further research is needed to determine optimal treatment for this condition.
Area of Science:
- Cardiology
- Hematology
- Nuclear Medicine
Background:
- Sickle cell anaemia (SCA) patients face risks of myocardial ischaemia.
- Conventional diagnostic methods for myocardial ischaemia in SCA lack sensitivity and specificity.
Purpose of the Study:
- To evaluate myocardial perfusion in children with SCA using thallium-201 (201Tl) single-photon emission computed tomography (SPECT).
Main Methods:
- Eight asymptomatic children with SCA underwent 201Tl-SPECT for myocardial perfusion assessment.
- Left ventricular ejection fraction (LVEF) was measured using radionuclide angiography.
Main Results:
- Abnormal myocardial perfusion was observed in 3 of 8 patients (2 reversible, 1 fixed defect).
- The mean LVEF was 53 +/- 8%.
- No correlation was found between myocardial perfusion and LVEF.
Conclusions:
- Myocardial ischaemia can be present in asymptomatic children with SCA.
- The optimal treatment for asymptomatic myocardial ischaemia in SCA requires further investigation.
- More aggressive management of the underlying sickle cell anaemia may be warranted.
Background:
Myocardial ischaemia is an unexpected complication with potentially serious clinical damages in patients with sickle cell anaemia (SCA). Conventional techniques, such as exercise testing and echocardiography, have low sensitivity and specificity for the detection of myocardial ischaemia in patients with SCA.
Objective:
To assess myocardial perfusion using thallium-201 (201Tl) single-photon emission computed tomography (SPECT) in children with SCA.
Materials And Methods:
Eight patients (11.5 +/- 5.0 years, mean +/- SD) who were free of cardiac symptoms were studied. Myocardial perfusion was assessed by 201Tl-SPECT after stress and 3 h later after a further injection. Left ventricular ejection fraction (LVEF) was assessed by equilibrium radionuclide angiography.
Results:
Myocardial perfusion was abnormal in three of eight patients: two had reversible defects and one had a fixed defect. The mean LVEF was 53 +/- 8%. There was no relationship between myocardial perfusion and LVEF.
Conclusions:
Treatment of asymptomatic myocardial ischaemia remains unclear, and more aggressive therapy of the haematological disease should be considered.