PB2315 ECHO HEART AND TISSUE DOPPLER ASSESSMENT AS EARLY PREDICTORS OF CARDIAC INJURIES IN SICKLE CELL PATIENTS

Background: Major cardiac abnormalities in patients with sickle cell disease are related to volume overload effects of chronic anemia and ferritin level. Patients with SCA have reduced LV global longitudinal strain. In the detection of subclinical LV dysfunction in patients presenting with sickle cell disease, 2D speckle tracking and tissue Doppler echocardiography appears to be useful to assess systolic dysfunction and diastolic dysfunction respectively. Aims: The aim of our study was to evaluate cardiac performance in adult Egyptian asymptomatic sickle cell patients. Methods: The study was conducted on 30 SCD patients who were recruited from the hematology clinic of Kasr El‐Ainy Hospital‐ Cairo University and 15 healthy control who were age and sex matched. Two‐dimensional speckle tracking echocardioghraphy (STE), M‐mode, Doppler and tissue Doppler echocardiography (TDE) were are used to assess systolic and diastolic dysfunction in both groups. We used parameters (GLS, AP3L, AP2L, AP4L, EF, LVIDS and LVIDd) for systolic dysfunction. And for diastolic dysfunction we used parameters (medial and lateral E/e’, E/A ratio, Dt and S velocity). Results: our results revealed significant increase in LVIDS and LVIDd dimensions in cases compared to control group (P < 0.001). None had an ejection fraction below 55%. Diastolic dysfunction was elicited in 8 patients (26%). There was a statistically significant correlation between the serum ferritin level and lateral E/E’ ratio. There was a significant reduction in GLS (p value.026) and also apical segments longitudinal strain (p value.002) compared to control. There was statistically significant negative correlation between number of sickle cell crises per year and GLS (p = 0.040). There was a statistical significant inverse correlation between Global LV systolic function and hemoglobin level (p = 0.04). Summary/Conclusion: Cardiac performance should include assessment of both systolic and diastolic parameters as there could be alteration in LV diastolic filling indices even in absence of systolic dysfunction. Hence these indices can be used as an early marker for cardiac affection. Speckle tracking echocardiography can recognize the cardiac involvement in really early stages and initiation of treatment and decreasing rate of painful crises to prevent irreversible myocardial dysfunction.