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Echocardiographic parameters to identify sickle cell patients with cardio-pathology

Simbo Chiadika1, Mary Lim-Fung1, Fiorella Llanos-Chea2

  • 1Division of Cardiology, Department of Internal Medicine, The University of Texas Health Science Center at Houston McGovern Medical School, Houston, TX, USA.

Echocardiography (Mount Kisco, N.Y.)
|May 15, 2018
PubMed

Insights

Sickle cell disease (SCD) significantly impacts heart function, with many patients showing abnormal cardiac parameters. Echocardiography can identify these abnormalities, aiding in risk assessment for better patient outcomes.

Area of Science:

  • Cardiology
  • Hematology
  • Medical Imaging

Background:

  • Sickle cell disease (SCD) is a genetic blood disorder causing chronic hemolytic anemia.
  • Anemia in SCD leads to vasculopathies, including pulmonary hypertension and cardiac dysfunction.
  • These cardiac abnormalities increase morbidity and mortality in SCD patients.

Purpose of the Study:

  • To assess the prevalence of echocardiographic parameters in patients with SCD.
  • To identify specific cardiac abnormalities associated with SCD.
  • To evaluate echocardiographic findings as potential indicators of cardiopulmonary risk in SCD.

Main Methods:

  • Retrospective analysis of 91 SCD patients (53% male, median age 30).
  • Measurement of laboratory and echocardiographic parameters, including left ventricular (LV) dimensions, ejection fraction (LVEF), myocardial performance index (MPI), mass index (MI), and left atrial volume index (LAVI).
  • Assessment of right heart dimensions, tricuspid regurgitation velocity (TRV), and tricuspid annular plane systolic excursion (TAPSE).

Main Results:

  • A high prevalence of left heart abnormalities was observed: 78% had abnormal LV MPI, 38% decreased LVEF, 24% increased LVMI, and 47% increased LAVI.
  • Right heart abnormalities were also common: 59% had increased pulmonary systolic pressure (PASP), 38% increased TRV, and 39% abnormal TAPSE.
  • Increased LVMI and LAVI were significantly associated with hemoglobin levels ≤8 g/dL.

Conclusions:

  • SCD is associated with a high prevalence of left and right heart abnormalities, including abnormal LV MPI, LVMI, diastolic function, LAVI, and PASP.
  • Echocardiographic parameters such as LV MPI and TAPSE are frequently abnormal in SCD patients.
  • These echocardiographic findings represent accessible prognostic tools for identifying cardiopulmonary risk in the SCD population.
Abstract

Keywords:
cardiomyopathydiastolic functionhemoglobinleft atrial volume indexmyocardial performance indextricuspid annular plane systolic excursion

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