Tidake Abhay, Gangurde Pranil, Taksande Anup, Mahajan Ajay, Nathani Pratap
Department of Cardiology,LTMMC and LTMGH,Sion,Mumbai,India.
Cardiol Young. 2015 Oct;25(7):1319-25. doi: 10.1017/S1047951114002455. Epub 2014 Dec 18.
Cardiovascular events and complications are the leading cause of mortality and morbidity in patients with sickle cell disease. Cardiac abnormalities occur frequently and at an early stage in sickle cell anaemia patients, despite being more evident in adulthood. Sickle cell anaemia patients are increasingly able to reach adulthood owing to improved healthcare, and may, therefore, suffer the consequences of chronic cardiac injury. Thus, the study of cardiac abnormalities is essential in children
The aim of this study was to determine the echocardiographic changes in left ventricular function in children suffering from sickle cell disease in Mumbai, Western India.
The study comprised of 48 cases of sickle cell anaemia and 30 non-anaemic controls with normal haemoglobin and electrophoresis pattern. M-mode, two-dimensional, and Doppler echocardiographic measurements of patients and controls were performed according to the criteria of the American Echocardiography Society.
On Doppler study, the A wave height was increased and the E/A ratio was decreased, whereas the deceleration and isovolumetric relaxation times were prolonged, which is typically seen in slowed or impaired myocardial relaxation (p<0.001). Although chamber dilatations were present, echocardiographic parameters showed no statistically significant correlation with severity of anaemia and age among the sickle cell patients.
We conclude that the increased left ventricular stiffness, compared with controls, might be due to fibrosis related to ischaemia caused by SS disease in addition to wall hypertrophy.
心血管事件和并发症是镰状细胞病患者死亡和发病的主要原因。心脏异常在镰状细胞贫血患者中频繁且早期出现，尽管在成年期更为明显。由于医疗保健的改善，镰状细胞贫血患者越来越能够活到成年，因此可能会遭受慢性心脏损伤的后果。因此，对儿童心脏异常的研究至关重要。
本研究的目的是确定印度西部孟买患有镰状细胞病的儿童左心室功能的超声心动图变化。
该研究包括48例镰状细胞贫血患者和30例血红蛋白及电泳模式正常的非贫血对照。根据美国超声心动图学会的标准，对患者和对照进行M型、二维和多普勒超声心动图测量。
在多普勒研究中，A波高度增加，E/A比值降低，而减速时间和等容舒张时间延长，这在心肌舒张减慢或受损时通常可见（p<0.001）。尽管存在心室扩张，但超声心动图参数在镰状细胞病患者中与贫血严重程度和年龄无统计学显著相关性。
我们得出结论，与对照组相比，左心室僵硬度增加可能是由于SS病导致的缺血相关纤维化以及心室壁肥厚。
