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Updated: Aug 8, 2025
Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
Published on: October 28, 2020
Echocardiographic Left Ventricular Hypertrophy and Geometric Patterns in Patients with Sickle Cell Anaemia
A M Abba1,2, A I Ladu1,2, A A Bukar1,2
1Department of Haematology and Blood Transfusion, University of Maiduguri Teaching Hospital, Maiduguri, Nigeria.
Insights
Left ventricular hypertrophy (LVH) is common in sickle cell anaemia (SCA). Prevalence varies by measurement criteria, with BSA indexing potentially overestimating LVH in SCA patients.
Area of Science:
- Cardiology
- Hematology
- Medical Imaging
Background:
- Left ventricular hypertrophy (LVH) is a frequent complication in sickle cell anaemia (SCA).
- LVH is linked to adverse cardiac outcomes, including dysfunction and sudden death.
- Prevalence estimates for LVH in SCA patients vary due to differing diagnostic criteria and body size considerations.
Purpose of the Study:
- To evaluate echocardiographic left ventricular hypertrophy (LVH) and geometric patterns in steady-state sickle cell anaemia (SCA) patients.
- To compare the prevalence of LVH using four distinct measurement criteria.
- To assess the impact of body size indexing on LVH prevalence in SCA.
Main Methods:
- Echocardiographic assessment of LVH and geometry in 82 steady-state SCA patients (≥18 years).
- LVH was defined by left ventricular mass (LVM), LVM indexed to body surface area (BSA), height, and height^2.7.
- Gender-specific reference values were used for all criteria.
Main Results:
- The prevalence of LVH was high across all applied criteria in SCA patients.
- LVH prevalence was highest when indexed to BSA (80.5%) and height (73.2%).
- Comparable prevalences were observed using LVM (68.3%) and LVM indexed to height^2.7 (69.5%).
Conclusions:
- LVH is highly prevalent in steady-state SCA patients, regardless of the diagnostic criteria.
- Eccentric LVH was the most common geometric pattern observed.
- Indexing LVM to BSA may overestimate LVH in SCA due to smaller body size; indexing to height^2.7 may offer a more accurate estimation.
Background:
Left ventricular hypertrophy (LVH) is a common complication in patients with sickle cell anaemia (SCA), and it has been associated with systolic and diastolic dysfunction, and sudden death. There is a wide variation in the reported prevalence of LVH in patients with SCA, partly due to the varying criteria applied, and the impact of small weight and body surface area (BSA) in SCA patients. We used four different criteria to determine echocardiographic LVH and geometric patterns in patients with steady-state SCA. Left ventricular hypertrophy was defined by LVM, LVM indexed to BSA, LVM indexed to height and LVM indexed to height2.7 using gender-specific reference values. Left ventricular geometry was determined using LVH and relative wall thickness.
Results:
Eighty-two patients with steady-state SCA, aged 18years and above were studied from January 2018 to April 2018. The median [IQR] age of the patients was 23 [10] years. Forty-seven (57.3%) were females. The prevalence of LVH was highest when LVM was indexed to BSA (80.5%), followed by LVM indexed to height (73.2%). Comparable prevalences of 68.3% and 69.5% were observed using LVM and LVM indexed to height2.7, respectively. The prevalence of LVH was similar in males and females for all the criteria.
Conclusion:
The prevalence of LVH is high among patients with steady-state SCA irrespective of the criteria applied. The most prevalent geometric pattern was eccentric LVH. Indexing to BSA might result in over-estimation of LVH given the relatively small BSA in patients with SCA. Indexing to height 2.7 might give a more accurate estimate of LVH.
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