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Coronary artery dilation and left ventricular hypertrophy do not predict morbidity in children with sickle cell

Mark C Johnson1, Micean J Johnikin, Joshua C Euteneuer

  • 1Division of Pediatric Cardiology, Department of Pediatrics, Washington University School of Medicine/St. Louis Children's Hospital, St. Louis, Missouri.

Pediatric Blood & Cancer
|September 30, 2014
PubMed

Insights

Coronary artery dilation (CAD) and left ventricular hypertrophy (LVH) are common in children with sickle cell disease (SCD). However, these findings do not predict future hospitalizations or intensive care unit admissions.

Area of Science:

  • Cardiology
  • Pediatrics
  • Hematology

Background:

  • The clinical significance of coronary artery dilation (CAD) and left ventricular hypertrophy (LVH) in pediatric sickle cell disease (SCD) is not well understood.
  • Existing research has not established a clear link between these cardiac abnormalities and patient morbidity.

Purpose of the Study:

  • To investigate the prevalence of CAD and LVH in children with SCD.
  • To determine if CAD and LVH predict future hospitalizations or intensive care unit (ICU) admissions in this population.

Main Methods:

  • A retrospective cohort study compared 101 children with SCD to 93 healthy African-American children.
  • Echocardiography was used to assess CAD and LVH.
  • Morbidity was measured by hospital days, number of admissions, and ICU admissions over a median follow-up of 6.1 years.

Main Results:

  • Left ventricular hypertrophy (LVH) was present in 46% of children with SCD and inversely related to age.
  • Prevalence of coronary artery dilation (CAD) was 49% for the left main coronary artery (LMCA), 29% for the left anterior descending (LAD), and 6% for the right coronary artery (RCA).
  • Neither CAD nor LVH predicted subsequent ICU admission, hospital days, or number of hospital admissions. They were also not associated with vaso-occlusive pain, acute chest syndrome, or cerebrovascular accident.

Conclusions:

  • LVH and CAD are frequent findings in children with SCD.
  • These cardiac abnormalities do not appear to be associated with increased risk for future hospital or ICU admissions in pediatric SCD patients.
Abstract

Keywords:
cardiac hypertrophycoronary dilationsickle cell disease

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