Evaluation of 107 patients with sickle cell anemia through tissue Doppler and myocardial performance index
Evaluation of 107 patients with sickle cell anemia through tissue Doppler and myocardial performance index
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DOI：
10.1016/j.echo.2007.06.001
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发表时间：
2008-10-01
影响因子：
6.5
通讯作者：
Barbosa, Marcia M.
中科院分区：
文献类型：
--
作者：
Caldas, Monica C.;Meira, Zilda A.;Barbosa, Marcia M.
背景：许多研究表明，镰状细胞性贫血（SCA）与心输出量增加和心脏扩大有关。近年来，心脏舒张功能不全和肺动脉高压在SCA患者中的表现较差。应使用新的收缩压和舒张压评价指标，以提供更多关于成人和儿童人群的信息。本研究的目的是确定两个心室的收缩和舒张功能，使用负荷无关的参数，并评估心脏的结果，由于输血或螯合治疗患者SCA.Methods：我们评估了107例SCA，年龄3至18岁（平均年龄，10.1 +/- 4.7岁）。对所有患者进行体格检查、心电图和多普勒超声心动图检查。结果：用心肌工作指数（MPI）评价两室收缩和舒张功能。与对照组相比，SCA患者左心室（P = .00）和右心室（P = .00）的MPI值均较高。通过二尖瓣舒张期血流和组织多普勒超声心动图评价舒张功能。患者E波减速时间高于对照组。患者被分为2组：第1组包括95名非输血患者，第2组包括12名接受长期输血治疗的患者。第1组患者的左心室质量明显大于第2组。收缩期和舒张功能没有不同的患者之间时，8克/分升的血红蛋白的截止值used.Conclusion：这多普勒超声心动图研究表明，收缩和舒张功能的早期异常可能发生在早期的SCA，即使是儿童和青少年在纽约心脏协会功能I和II类。
Background: Sickle-cell anemia (SCA) is associated with elevated cardiac output and cardiomegaly, as demonstrated in many studies. Recently, diastolic dysfunction and pulmonary hypertension have been shown to have poor prognoses in patients with SCA. New indexes of systolic and diastolic evaluation should be used to give more information on both the adult and the pediatric populations. The objectives of this study were to determine the systolic and diastolic function of both ventricles using load-independent parameters and to evaluate cardiac findings due to transfusion or chelation therapy in patients with SCA.Methods: We evaluated 107 patients with SCA, aged 3 to 18 years (mean age, 10.1 +/- 4.7 years). Physical exams, electrocardiography, and Doppler echocardiography were performed in all patients. These patients were compared with 70 normal children and adolescents.Results: Combined systolic and diastolic function of both ventricles was evaluated by the myocardial performance index (MPI). MPI values were higher both in the left ventricles (P = .00) and in the right ventricles (P = .00) of patients with SCA compared with controls. Diastolic function was evaluated by diastolic mitral valve flow and by tissue Doppler echocardiography. E-wave deceleration time was higher in patients than in controls. Patients were divided into 2 groups: group 1 consisted of 95 nontransfused patients and group 2 of 12 patients on chronic transfusion therapy. Group 1 patients demonstrated significantly larger left ventricular mass than those in group 2. Systolic and diastolic function did not differ between patients when an 8 g/dL cutoff value of hemoglobin was used.Conclusion: This Doppler echocardiographic study showed that early abnormalities in systolic and diastolic function can occur at an early age in SCA, even among children and adolescents in New York Heart Association functional classes I and II.