Right Ventricular Systolic Strain Is Altered in Children with Sickle Cell Disease
Right Ventricular Systolic Strain Is Altered in Children with Sickle Cell Disease
复制标题
DOI：
10.1016/j.echo.2012.01.011
复制
发表时间：
2012-05-01
影响因子：
6.5
通讯作者：
Boudjemline, Younes
中科院分区：
文献类型：
--
作者：
Blanc, Julie;Stos, Bertrand;Boudjemline, Younes
背景：几项成人研究表明镰状细胞病与心脏异常和过早死亡有关。本研究的目的是使用斑点追踪应变，一个相对不依赖负荷的参数，来评估儿童镰状细胞病人群的左心室（LV）和右心室（RV）收缩功能。（平均年龄，10.0 ± 3.6岁;平均体表面积，1.14 ± 0.27 m2）和29名年龄和体表面积匹配的对照组进行了比较。心输出量，LV尺寸，壁厚和周向应变，LV和RV纵向收缩应变，常规和组织多普勒参数，和肺动脉压进行了assessed.Results：LV心输出量显着较高的患者，作为索引LV收缩直径，索引LV质量，和E/E'间隔比。患者和对照组的左室舒张期内径、室壁厚度、左室缩短分数和左室纵向和周向应变指数相似。然而，尽管三尖瓣环平面收缩期偏移和彩色编码的三尖瓣S波速度相似，但他们的整体RV纵向应变显著较低。在患者中，21%的三尖瓣返流速度> 2.5 m/sec，但无三尖瓣返流速度> 3 m/sec。血红蛋白< 80 g/L的患者的左心室舒张期指数和肺动脉收缩压显着较高，但左心室收缩期和舒张期功能参数相似。结论：在镰状细胞病儿童中，左心室舒张功能显着改变，尽管通过整体纵向应变评估的左心室收缩功能正常。此外，心输出量增加，三尖瓣返流速度升高是常见的，而在对照组中从未发现。最重要的是，整体RV纵向收缩应变显著改变。（J Am Soc Echocardiogr 2012;25：511-7.）
Background: Several adult studies have shown that sickle cell disease is associated with cardiac abnormalities and premature death. The aim of this study was to use speckle-tracking strain, a relatively load independent parameter, to evaluate systolic left ventricular (LV) and right ventricular (RV) function in a pediatric sickle cell disease population.Methods: Twenty-eight patients with sickle cell disease (mean age, 10.0 +/- 3.6 years; mean body surface area, 1.14 +/- 0.27 m(2)) and 29 controls matched for age and body surface area were compared. Cardiac output, LV dimension, wall thickness and circumferential strain, LV and RV longitudinal systolic strain, conventional and tissue Doppler parameters, and pulmonary pressure were assessed.Results: LV cardiac output was significantly higher in patients, as were indexed LV systolic diameter, indexed LV mass, and E/E' septal ratio. Indexed LV diastolic diameter, wall thickness, LV shortening fraction, and global LV longitudinal and circumferential strains were similar in patients and controls. However, their global RV longitudinal strain was significantly lower, although tricuspid annular plane systolic excursion and color-coded tricuspid S-wave velocity were similar. Among patients, 21% had tricuspid regurgitation velocities > 2.5 m/sec, but none had tricuspid regurgitation velocities > 3 m/sec. Indexed LV diastolic dimension and systolic pulmonary artery pressure were significantly higher in patients whose hemoglobin was < 80 g/L, but parameters of systolic and diastolic LV function were similar.Conclusions: In children with sickle cell disease, LV diastolic function is significantly altered, although LV systolic function, evaluated by global longitudinal strain, is normal. In addition, cardiac output is increased, and elevated tricuspid regurgitation velocity is common, whereas it is never found in controls. Most importantly, global RV longitudinal systolic strain is significantly altered. (J Am Soc Echocardiogr 2012;25:511-7.)