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Frequency of diastolic dysfunction in patients with sickle cell anaemia: a tissue Doppler imaging study
Mehmet Kanadaşi1, Onur Akpinar, Murat Cayli
1Cukurova University, School of Medicine, Faculty of Medicine, Cardiology Department, Adana, Turkey. kanadasi@cu.edu.tr
Insights
Left ventricular diastolic dysfunction is uncommon in sickle cell anaemia patients without heart failure. Pulsed wave tissue Doppler imaging (TDI) is a reliable method for assessing diastolic function, proving more accurate than traditional methods.
Area of Science:
- Cardiology
- Hematology
- Medical Imaging
Background:
- Sickle cell anaemia (SCA) can lead to cardiac complications, including systolic dysfunction.
- Diastolic dysfunction in SCA patients is inconsistently reported using traditional echocardiography.
Purpose of the Study:
- To investigate left ventricular diastolic function in SCA patients without heart failure.
- To evaluate the utility of pulsed wave tissue Doppler imaging (TDI) in assessing diastolic function in SCA.
Main Methods:
- Compared 31 SCA patients (without heart failure) to 31 healthy controls.
- Utilized both traditional pulsed wave Doppler (PWD) and TDI for echocardiographic assessment.
- Evaluated left ventricular diastolic function parameters.
Main Results:
- SCA patients showed increased cardiac dimensions and velocities compared to controls.
- Diastolic dysfunction was detected in 22.6% by PWD versus 9.7% by TDI.
- TDI identified 4 patients with PWD-detected restrictive patterns as having normal diastolic function.
Conclusions:
- Left ventricular diastolic dysfunction is infrequent in SCA patients without heart failure.
- TDI is a more reliable and simpler method for evaluating diastolic function in SCA.
- TDI reevaluation is recommended for SCA patients with restrictive patterns identified by PWD.
Objective:
Although cardiac dilatation and systolic dysfunction have been well documented as a late manifestation, there are conflicting reports regarding the diastolic dysfunction, by using traditional echocardiographic methods in patients with sickle cell anaemia (SCA). The aim of this study was to investigate left ventricular diastolic function in SCA patients without congestive heart failure by using pulsed wave tissue Doppler imaging (TDI).
Methods:
Thirty-one patients (18 men and 13 women, mean age: 26.4 +/- 8.5 years) with homozygous SCA without congestive heart failure and 31 healthy control subjects (19 men and 12 women, mean age: 26.5 +/- 7.6 years) were enrolled in the study. All patients and the controls underwent echocardiographic examination. Left ventricular diastolic function was evaluated by using both traditional pulsed wave Doppler (PWD) and TDI.
Results:
The cardiac chamber dimensions, wall thicknesses, E and A transmitral peak diastolic velocities, systolic (Sm), early (Em) and late (Am) diastolic myocardial velocities were significantly increased in the patients compared to the controls. Diastolic dysfunction was found in 7 (22.6%) and 3 (9.7%) patients by PWD and TDI, respectively. Of the 7 patients with diastolic abnormalities, 4 patients with a restrictive pattern by PWD were found to be normal by TDI.
Conclusion:
Our results show that left ventricular diastolic dysfunction is not a frequent finding in patients with SCA without congestive heart failure and TDI is a more reliable and easy method to evaluate diastolic function. Patients with a restrictive pattern found by PWD should be reevaluated by using TDI.
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