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Subclinical left ventricular systolic impairment in steady state young adult patients with sickle-cell anemia

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Abstract

Chronic volume overload in sickle-cell anemia (SCA) is associated with left ventricular (LV) enlargement and hypertrophy. The effect of the disease on LV systolic function remains debated. The aim of our study was to investigate LV systolic function in SCA patients using 2D speckle-tracking imaging. We compared 30 steady state asymptomatic adult SCA patients (17 women, mean age 24.7 ± 5.1 years) with 30 age and sex-matched healthy subjects (17 women, mean age 25.0 ± 4.9 years). In addition to conventional echocardiographic parameters including LV ejection fraction (LVEF) and LV mass index (LVMi), global longitudinal strain (GLS) and strain rate (GLSR) were measured. GLS (−17.9 ± 2.0 vs. −19.7 ± 2.5 %, p = 0.004) and GLSR (−0.92 ± 0.09 vs. −1.07 ± 0.17 s−1, p < 0.0001) values were lower in SCA patients while LVEF values (60.1 ± 3.8 vs. 61.7 ± 4.7 %, p = 0.30) were not different. LVMi was increased in SCA patients (100.7 ± 23.5 vs. 72.4 ± 15.2 g/m2, p = 0.0001) and GLSR was significantly lower in the subgroup of patients with LV hypertrophy (−0.88 ± 0.09 vs. −0.96 ± 0.08 s−1, p = 0.02). In SCA patients LVMi was correlated to GLS (r = 0.58, p = 0.001) and GLSR (r = 0.45, p = 0.015) pleading in favor of a pathological LV remodeling. Asymptomatic SCA patients exhibited a subclinical alteration of LV systolic function. Myocardial dysfunction appears to be linked to the degree of LV hypertrophy. 2D speckle-tracking imaging might be useful for long-term follow-up and to study the natural course of LV dysfunction in SCA patients.

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Authors and Affiliations

  1. Department of Cardiology, Institut de Cardiologie, Pitié-Salpêtrière Hospital (Groupe Hospitalier Pitié-Salpêtrière), Assistance Publique – Hôpitaux de Paris, 47-83, boulevard de l’Hôpital, 75651, Paris Cedex 13, France

    Nadjib Hammoudi, Dimitri Arangalage, Morad Djebbar, Richard Isnard & Pierre-Louis Michel

  2. Department of Internal Medicine, Reference Center for Adult Sickle-Cell Disease, Tenon Hospital, Assistance Publique – Hôpitaux de Paris, Paris, France

    Katia Stankovic Stojanovic, Robert Girot & François Lionnet

  3. Department of Cardiology, Saint Antoine Hospital, Assistance Publique – Hôpitaux de Paris, Paris, France

    Magali Charbonnier

  4. Faculté de Médecine Pierre et Marie Curie, University Paris 6, Paris, France

    Nadjib Hammoudi, Morad Djebbar, Richard Isnard, Robert Girot, Pierre-Louis Michel & François Lionnet

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  1. Nadjib Hammoudi
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Correspondence to Nadjib Hammoudi.

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Hammoudi, N., Arangalage, D., Djebbar, M. et al. Subclinical left ventricular systolic impairment in steady state young adult patients with sickle-cell anemia. Int J Cardiovasc Imaging 30, 1297–1304 (2014). https://doi.org/10.1007/s10554-014-0473-1

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  • DOI: https://doi.org/10.1007/s10554-014-0473-1

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