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Echocardiographic findings in mild and severe forms of sickle cell anemia
1Department of Pediatric Hematology, Cukurova University Medical Faculty, Balcali, Adana, Turkey.
Insights
M-mode echocardiography reveals enlarged left heart chambers in children with sickle cell anemia, regardless of disease severity. Despite volume overload, cardiac systolic function remains normal in affected children.
Area of Science:
- Pediatric Cardiology
- Hematology
- Medical Imaging
Background:
- Sickle cell anemia (SCA) is a genetic blood disorder with potential cardiac complications.
- Echocardiography is crucial for assessing cardiac structure and function in pediatric patients.
Purpose of the Study:
- To compare M-mode echocardiographic findings between children with sickle cell anemia and healthy controls.
- To investigate potential cardiac structural changes associated with SCA severity.
Main Methods:
- M-mode echocardiography was performed on 30 children with SCA (12 mild, 18 severe) and 12 healthy children.
- Echocardiographic parameters including left atrium dimension, left ventricle dimensions, posterior wall thickness, and fractional shortening were analyzed.
Main Results:
- Children with SCA, both mild and severe, exhibited increased left atrium and left ventricle end-diastolic dimensions compared to controls.
- Posterior left ventricle thickness and left ventricle mass were also elevated in SCA groups.
- Left ventricular fractional shortening and systolic function remained normal despite cardiac volume load and dilatation.
Conclusions:
- Sickle cell anemia is associated with significant cardiac chamber enlargement, particularly the left atrium and left ventricle.
- Cardiac systolic function is preserved in pediatric SCA patients despite echocardiographic evidence of volume overload.
- Echocardiographic findings did not correlate with hematological indices in this cohort.
Abstract:
M-mode echocardiographic findings were compared between sickle cell anemic and healthy children. Patients were composed of two groups; Group 1: mild group with no crises, no blood transfusions at the ages of 5.0 to 13.0, total of 12 children; Group 2: severe group, with frequent crises with requirement of blood transfusions at the ages of 3.0 to 13.0 years, total of 18 children. Control group was composed of 12 healthy children aged 5.0 to 13.0. When M-mode echocardiographic findings were compared, important findings were as follows: Mean left atrium dimension was increased both in the mild and severe groups (P < 0.001) compared with controls. This finding also supports the increase in the left ventricle end-diastolic dimension in both the severe and mild groups as compared with controls (P < 0.001). The increase in end-diastolic left ventricle dimension could be due to anemia present in the patients, but there was no difference between the two patient groups. Posterior left ventricle thickness and left ventricle mass was increased in both the mild and severe groups compared with controls (P < 0.001, P < 0.05), respectively. Left ventricular fractional shortening was more or less the same with controls. In spite of left ventricular volume load and dilatation, left ventricular contraction was good and systolic function was normal, and there was no correlation between the ECHO findings and hematological indices.