Subclinical Cardiac Dysfunction Is Associated With Extracardiac Organ Damages

Area of Science:

• Cardiology
• Hematology
• Public Health

Background:

• Previous research on sickle cell disease (SCD) primarily from Western countries highlights cardiac remodeling and diastolic dysfunction.
• Sub-Saharan Africa bears the highest burden of SCD, necessitating localized studies on cardiac involvement.
• The CADRE study investigated cardiac status in SCD patients within this high-prevalence region.

Purpose of the Study:

• To assess cardiac involvement in sickle cell disease (SCD) patients in sub-Saharan Africa.
• To compare echocardiographic features between SCD patients and healthy controls.
• To determine the association between cardiac abnormalities and vascular complications in SCD.

Main Methods:

• Transthoracic echocardiography was performed on 612 SCD patients and 149 healthy controls aged ≥10 years in Cameroon, Mali, and Senegal.
• Clinical and echocardiographic data were compared between SCD patients and controls.
• Associations between echocardiographic findings and SCD-related vascular complications were analyzed.

Main Results:

• SCD patients exhibited significantly more dilated and hypertrophic left and right cardiac chambers and lower systemic vascular resistances compared to controls.
• Left ventricular ejection fraction did not differ between groups.
• Increased left ventricular mass index, cardiac dilatation, cardiac output, and decreased systemic vascular resistances were associated with a history of extracardiac organ damage in SCD patients.

Conclusions:

• Cardiac dilatation, hypertrophy, increased cardiac output, and altered systemic vascular resistance are prevalent in sub-Saharan African SCD patients, correlating with extracardiac complications.
• Despite subclinical cardiac abnormalities, the prevalence of clinical heart failure was low.
• Further research is warranted to explore the prognostic significance of subclinical cardiac involvement in sickle cell disease.