DOI: https://dx.doi.org/10.18203/2349-3933.ijam20220780
Published: 2022-03-24

A study of left ventricular diastolic dysfunction in patients of sickle cell disease

Mohita Shah, Prafful Kothari

Abstract


Background: Left ventricular diastolic filling patterns are altered in patients with sickle cell anaemia and these diastolic abnormalities may be present in the absence of heart failure. These abnormal patterns suggest an intrinsic myocardial abnormality in patients with sickle cell anaemia and may prove to be early markers of cardiac disease. The ventricles do not properly relax and become stiff meaning they cannot fill with blood properly.

Methods: This study was carried out in tertiary health care hospital in western India, where homozygous sickle cell disease patients and age and haemoglobin matched controls were taken into cross sectional observational study design.

Results: The mean values of E, A, E/A, IVRT, DT, AT, were in normal range in controls. In cases although the mean values of E, A, E/A, IVRT, DT, AT were in normal range, there were 19 cases of sickle cell anaemia who had significant alteration in indices of diastolic LV function from normal range. Out of these 20 cases with diastolic dysfunction, 11 cases had significant increase in (E) velocity from normal range with E/A ratio more than 2 suggestive of restrictive filling pattern of diastolic dysfunction while in 8 cases E value was less than normal with increase in (A) velocity and E/A ratio was less than 1 suggestive of impaired relaxation pattern of diastolic dysfunction. When indices of diastolic LV function were compared in cases and controls, mean early peak filling velocity (E) was significantly higher in cases.  

Conclusions: In present study, out of 37 cases 19 (51%) cases had LV diastolic dysfunction. Of these 19 cases with diastolic dysfunction, 11 cases had restrictive filling pattern and 8 cases had impaired relaxation pattern of diastolic dysfunction.


Keywords


Sickle cell disease, LV diastolic dysfunction, Systolic dysfunction

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References


Zilberman MV, Du W, Das S, Sarnaik SA. Evaluation of left ventricular diastolic function in pediatric sickle cell disease patients. Am J Hematol. 2007;82(6):433-8.

Eddine AC, Alvarez O, Lipshultz SE, Kardon R, Arheart K, Swaminathan S. Ventricular structure and function in children with sickle cell disease using conventional and tissue Doppler echocardiography. Am J Cardiol. 2012;109(9):1358-64.

Morissens M, Hammer T, Azerad MA, Efira A, Rodriguez JC. Evaluation of Cardiac Function in Patients with Sickle Cell Disease with Left Ventricular Global Longitudinal Strain. J Transl Int Med. 2020;8(1):41-7.

Whipple NS, Joshi VM, Naik RJ, Mentnech T, McFarland MM, Nolan VG, Hankins JS. Sickle cell disease and ventricular myocardial strain: A systematic review. Pediatr Blood Cancer. 2021;68(6):28973.

Hockham C, Bhatt S, Colah R, Mukherjee MB, Penman BS, Gupta S, et al. The spatial epidemiology of sickle-cell anaemia in India. Sci Rep. 2018;8(1):17685.

Barbosa MM, Vasconcelos MC, Ferrari TC, Fernandes BM, Passaglia LG, Silva CM, et al. Assessment of ventricular function in adults with sickle cell disease: role of two-dimensional speckle-tracking strain. J Am Soc Echocardiogr. 2014;27(11):1216-22.

Youssry I, Shaltout MF, Massih AF, Ghobrial C, Nabih M, Doss R, et al. Right ventricular functions in subphenotypes of sickle cell disease. J Saudi Heart Assoc. 2020;32(1):34-9.

Niss O, Quinn CT, Lane A, Daily J, Khoury PR, Bakeer N, et al. Cardiomyopathy With Restrictive Physiology in Sickle Cell Disease. JACC Cardiovasc Imaging. 2016;9(3):243-52.

Gbotosho OT, Taylor M, Malik P. Cardiac pathophysiology in sickle cell disease. J Thromb Thrombolysis. 2021;52(1):248-59.

Kingue S, Mbanya D, Tapko B, Nguegno A. Diastolic function of left ventricle in a North-African patient with homozygous sickle cell anemia. Ann Cardiol Angeiol. 2000;49:351-61.

Martins W, Mesquita ET, Cunha DM, Pinheiro LA, Romêo FLJ, Pareto RC. Doppler echocardiographic study in adolescents and young adults with sickle cell anemia. Arq Bras Cardiol. 1999;73(6):463-74.

Taksande A, Vilhekar K, Jain M, Ganvir B. Left ventricular systolic and diastolic functions in patients with sickle cell anemia. Indian Heart J. 2005;57(6):694-7.