Department of Pediatrics, Faculty of Medicine, Taibah University, Al-Madinah Al-Munawwarah, Saudi Arabia.
Department of Pediatrics, Faculty of Medicine, Taibah University, Al-Madinah Al-Munawwarah, Saudi Arabia.
Arch Med Res. 2015 Aug;46(6):462-9. doi: 10.1016/j.arcmed.2015.08.002. Epub 2015 Aug 24.
The extent in which sickle cell anemia (SCA) impacts myocardial function in children is unclear. Doppler tissue imaging (DTI) was introduced as a new non-invasive echocardiographic method for assessment of ventricular systolic and diastolic functions. We undertook this study to assess subclinical impact of SCA on global myocardial performance in affected children using DTI and to correlate it with mean hemoglobin concentration.
Eighty five children with SCA (mean age 11.82 ± 3.7 years) was included as the study group and 55 age- and sex-matched healthy children as the control group. Conventional two-dimensional echocardiography was performed in both groups and DTI was used to determine right ventricular (RV) and left ventricular (LV) Tei indexes. Mean Hb concentration was correlated to the cardiac functions of SCA children.
RV and LV Tei indexes were significantly higher in SCA group (mean ± SD: 0.54 ± 0.19 vs. 0.27 ± 0.01, p <0.0001 and 0.47 ± 0.09 vs. 0.30 ± 0.07, p <0.0001, respectively). Also, mean Hb concentration was correlated negatively with both LV Tei index (r = -0.611, p <0.0001) and with RV Tei index (r = -0.894, p <0.0001). On the contrary, fractional shortening (FS) did not correlate with mean Hb concentration (r = -0.044, p = 0.681).
DTI technique appears to be more sensitive than conventional echocardiography in the early detection of myocardial dysfunction in children with SCA. This provides insights into the value of early screening and the potential for preventive therapy in children to avert cardiac morbidity and mortality in adults with SCA.
镰状细胞贫血（SCA）对儿童心肌功能的影响程度尚不清楚。多普勒组织成像（DTI）作为一种新的非侵入性超声心动图方法，用于评估心室收缩和舒张功能。我们进行这项研究，旨在使用 DTI 评估 SCA 对受影响儿童整体心肌功能的亚临床影响，并将其与平均血红蛋白浓度相关联。
纳入 85 例 SCA 患儿（平均年龄 11.82±3.7 岁）作为研究组，55 例年龄和性别匹配的健康儿童作为对照组。对两组均进行常规二维超声心动图检查，并使用 DTI 测定右心室（RV）和左心室（LV）的 Tei 指数。将平均 Hb 浓度与 SCA 患儿的心脏功能相关联。
SCA 组的 RV 和 LV Tei 指数明显升高（平均值±标准差：0.54±0.19 与 0.27±0.01，p<0.0001 和 0.47±0.09 与 0.30±0.07，p<0.0001，分别）。此外，平均 Hb 浓度与 LV Tei 指数（r=-0.611，p<0.0001）和 RV Tei 指数（r=-0.894，p<0.0001）呈负相关。相反，缩短分数（FS）与平均 Hb 浓度无相关性（r=-0.044，p=0.681）。
与常规超声心动图相比，DTI 技术在早期检测 SCA 儿童心肌功能障碍方面似乎更敏感。这深入了解了早期筛查的价值以及对儿童进行预防性治疗的潜力，以避免 SCA 成年患者的心脏发病率和死亡率。
