Ventricular structure and function in children with sickle cell disease using conventional and tissue Doppler...

Area of Science:

• Pediatric Cardiology
• Hematology
• Cardiovascular Imaging

Background:

• Sickle cell disease (SCD) can affect cardiac function, but assessments in children are inconsistent.
• Conventional echocardiography may not fully capture subtle myocardial changes in pediatric SCD.
• Tissue Doppler echocardiography (TDE) offers enhanced insights into myocardial function.

Purpose of the Study:

• To evaluate left ventricular (LV) and right ventricular function in children with SCD using TDE.
• To compare TDE findings in children with SCD to healthy controls.
• To correlate cardiac function measurements with clinical characteristics and hemoglobin levels.

Main Methods:

• Compared 54 children with SCD to 55 healthy controls using 2D, M-mode, spectral Doppler, and TDE.
• Assessed LV and RV systolic and diastolic function, pulmonary artery pressure (TRJV).
• Correlated echocardiographic data with hemoglobin levels and treatment modalities (transfusion, hydroxyurea).

Main Results:

• Children with SCD showed LV hypertrophy and dilation, with 30% having elevated pulmonary artery pressure.
• Conventional echocardiography revealed normal LV systolic and diastolic function.
• TDE identified LV diastolic dysfunction in 31% of SCD children, correlating with lower hemoglobin levels.

Conclusions:

• A significant proportion of children with SCD exhibit TDE-detectable LV diastolic dysfunction.
• Lower hemoglobin levels are associated with cardiac changes, including LV diastolic dysfunction.
• Serial TDE assessments may aid in early detection of cardiac abnormalities in pediatric SCD, especially those with anemia.