Abnormal myocardial flow reserve in sickle cell disease: a myocardial contrast echocardiography study

Area of Science:

• Cardiology
• Echocardiography
• Hematology

Background:

• Sickle cell disease (SCD) involves microvascular obstruction, leading to ischemia and necrosis.
• Cardiac involvement is a significant concern in SCD patients.
• The relationship between myocardial perfusion and left ventricle (LV) function in SCD requires further investigation.

Purpose of the Study:

• To determine if myocardial contrast echocardiography (MCE) can detect myocardial perfusion abnormalities in SCD patients.
• To assess the correlation between MCE-derived perfusion indices and LV systolic function in SCD.

Main Methods:

• A study involving 25 SCD patients and 19 healthy controls.
• Myocardial perfusion reserve indices (A, beta, A x beta) were measured using MCE before and after dipyridamole-induced hyperemia.
• Left ventricle (LV) systolic function was assessed using ejection fraction (EF), index of myocardial performance (IMP), E/Ea ratio, Sa, and S%.

Main Results:

• SCD patients exhibited significantly lower myocardial velocity (beta) and myocardial blood flow (A x beta) reserves compared to controls (P < 0.001).
• In SCD patients, beta reserve correlated with EF, IMP, Sa, E/Ea, and S%.
• A x beta reserve showed a correlation with Sa in SCD patients.

Conclusions:

• MCE effectively detects abnormal myocardial perfusion reserve in individuals with SCD.
• The detected perfusion abnormalities are significantly correlated with indices of systolic function.
• These findings suggest that impaired myocardial perfusion contributes to ventricular dysfunction in SCD.