Benites Bruno Deltreggia, Cisneiros Ianara Silva, Bastos Stephany Oliveira, Lino Ana Paula Beppler Lazaro, Costa Fernando Ferreira, Gilli Simone Cristina Olenscki, Saad Sara Teresinha Olalla
Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil.
Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil.
Hematol Transfus Cell Ther. 2019 Apr-Jun;41(2):158-163. doi: 10.1016/j.htct.2018.09.003. Epub 2018 Dec 31.
We evaluated possible relationships between echocardiographic findings and clinical and laboratory parameters, in a cohort of Brazilian patients diagnosed with sickle cell/β-thalassemia, to better understand the cardiac involvement in this disease.
Left atrial (LA) and left ventricular (LV) dilation were found in 19.5 and 11% of patients, respectively; systolic left ventricular dysfunction was present in a single patient. There were no differences in masses and volumes of cardiac chambers comparing Sβ with Sβ patients, and no relationship between these parameters and specific complications of the disease. However, parameters of altered ventricular geometry were significantly correlated with serum creatinine, hepatic transaminases and bilirubin levels. Moreover, 3 patients presented stroke; they were significantly older [53 (41-56)×37.5 (18-70), p=0.048], had higher values of LV posterior wall diastolic thickness [10 (10-11)×8 (6-14), p=0.03], LV mass [226 (194-260)×147 (69-537), p=0.039] and LA/aortic ratio [1.545 (1.48-1.61)×1.26 (0.9-1.48), p=0.032].
Cardiac involvement in this disease does not appear to depend on the thalassemia phenotype. The presence of signs of myocardial remodeling in this group of patients was related to multi-organ impairment and rendered a higher propensity for stroke in older patients, suggesting the need for greater vigilance and control of associated factors.
我们评估了一组被诊断为镰状细胞/β地中海贫血的巴西患者超声心动图检查结果与临床及实验室参数之间的可能关系,以更好地了解该疾病的心脏受累情况。
分别在19.5%和11%的患者中发现左心房(LA)和左心室(LV)扩张;仅1例患者存在左心室收缩功能障碍。比较Sβ与Sβ患者时,心腔的质量和容积无差异,且这些参数与该疾病的特定并发症之间无相关性。然而,心室几何形态改变的参数与血清肌酐、肝转氨酶和胆红素水平显著相关。此外,3例患者发生中风;他们年龄显著更大[53(41 - 56)×37.5(18 - 70),p = 0.048],左心室后壁舒张厚度[10(10 - 11)×8(6 - 14),p = 0.03]、左心室质量[226(194 - 260)×147(69 - 537),p = 0.039]和左心房/主动脉比值[1.545(1.48 - 1.61)×1.26(0.9 - 1.48),p = 0.032]更高。
该疾病的心脏受累似乎不取决于地中海贫血表型。这组患者中存在心肌重塑迹象与多器官损害有关,且使老年患者发生中风的倾向更高,提示需要更加警惕并控制相关因素。