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Left Ventricular Dyssynchrony Is an Early Manifestation of Heart Involvement in Sickle Cell Anemia
Author(s) -
Karakaş Mehmet Fatih,
Büyükkaya Eyüp,
Kurt Mustafa,
Çelik Murat,
Karakaş Esra,
Büyükkaya Şule,
Akçay Adnan Burak,
Sen Nihat
Publication year - 2013
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.12085
Subject(s) - cardiology , medicine , ventricular dyssynchrony , diastole , qrs complex , ejection fraction , sickle cell anemia , blood pressure , heart failure , cardiac resynchronization therapy , disease
Background Sickle cell anemia ( SCA ) is the most common inherited anemia. Although heart involvement in SCA is well‐established, there is no data about changes of contraction synchrony in SCA . Therefore, we aimed to study the left ventricular contraction synchrony in SCA patients with narrow QRS and normal ejection fraction ( EF ). Methods Thirty‐six patients with SCA and 37 age‐ and gender‐matched control subjects were included in the study. Left ventricular dyssynchrony was investigated by color‐coded tissue D oppler imaging. Results The SCA patients had lower hemoglobin (Hb) and higher ferritin, left ventricular end‐diastolic diameter, left ventricular end‐systolic diameter, left ventricular mass index ( LVMI ), and pulmonary artery pressure. Peak A velocity, Dt, and E/E′ values were higher in the SCA group however, E/A ratio and average Em were higher in the control group. LV systolic dyssynchrony parameters including Ts‐ SD ‐12, Ts‐12, Ts‐ SD ‐6, and Ts‐6 were found to be higher in SCA group when compared with controls. In addition to that, the patients with ventricular dyssynchrony (a Ts‐ SD ‐12 > 34.4 msec) were higher in the SCA group than the control group (55.6% vs. 8.1%, P < 0.001). In the correlation analysis, systolic dyssynchrony parameters were found to be correlated with Hb, ferritin, LVMI , E/A, Dt, Em. Conclusion Our results revealed that in SCA patients with normal EF and narrow QRS , left ventricular systolic dyssynchrony was an early manifestation of heart involvement and might be coexisted with or preceding diastolic dysfunction.