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Left ventricular filling in sickle cell anemia
I C Balfour1, W Covitz, F W Arensman
1Section of Pediatric Cardiology, St. Louis University Medical Center, Missouri 63104.
The American Journal of Cardiology
|February 1, 1988
Summary
Sickle cell anemia patients show impaired left ventricular diastolic and systolic function, impacting exercise tolerance. Echocardiography revealed abnormalities exacerbated by exercise, leading to reduced ejection fraction response.
Area of Science:
- Cardiology
- Hematology
- Medical Imaging
Background:
- Sickle cell anemia (SCA) is a genetic blood disorder that can affect multiple organ systems.
- Cardiac involvement, particularly left ventricular (LV) dysfunction, is a known complication of SCA.
- Understanding LV systolic and diastolic function is crucial for managing SCA patients and predicting exercise capacity.
Purpose of the Study:
- To evaluate left ventricular (LV) systolic and diastolic function in patients with sickle cell anemia (SCA) at rest and during exercise.
- To compare cardiac function between SCA patients with normal and abnormal ejection fraction (EF) responses to exercise.
- To investigate the relationship between cardiac dysfunction and exercise intolerance in SCA.
Main Methods:
- M-mode echocardiography was used to assess LV systolic and diastolic function in 11 healthy controls and 38 SCA patients at rest.
- Radionuclide exercise tests were performed on SCA patients to determine EF response to exercise.
- SCA patients were categorized into groups with normal (EF response > 70%) and abnormal (EF response < 60%) EF responses to exercise.
Main Results:
- Patients with SCA exhibited impaired diastolic function (reduced LV filling) compared to normal subjects.
- The abnormal EF response group showed significantly more impaired diastolic function and performed less exercise than the normal EF response group.
- Both SCA groups experienced a decrease in LV end-diastolic volume during exercise, with abnormalities in systolic and diastolic function becoming more pronounced at higher heart rates.
Conclusions:
- Sickle cell anemia is associated with abnormalities in both systolic and diastolic LV function.
- Impaired cardiac function, particularly diastolic dysfunction, contributes to reduced exercise tolerance and abnormal EF response in SCA patients during exercise.
- Echocardiographic and radionuclide assessments are valuable tools for identifying cardiac dysfunction in SCA.