| Evaluation of left ventricular systolic function in pediatric sickle cell anemia patients using the end-systolic wall stress-velocity of circumferential fiber shortening relationship. | |
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MedLine Citation:
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PMID: 16750697 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: The aim of this work was to evaluate myocardial contractility using the end-systolic wall stress (ESSm)-velocity of circumferential fiber shortening (VCFc) relationship in sickle cell anemia (SCA) patients compared with a similar age group of African-American (AA) control patients. BACKGROUND: Abnormalities of myocardial function have been documented in SCA patients using load-dependent echocardiographic indexes. Whether the systolic dysfunction results from impaired myocardial contractility or altered loading conditions is unknown because controlled studies using a load-independent measure of contractility have not been performed. METHODS: Fifty healthy AA patients and 57 SCA patients age 3 months to 18 years were studied. Simultaneous indirect arterial pulse tracing, phonocardiogram, electrocardiogram, and M-mode tracing of the left ventricular (LV) short-axis were recorded. The LV dimensions, corrected ejection time (ETc), percent fractional shortening (%FS), VCFc, and ESSm were determined. The ESSm-VCFc relationship was calculated and compared between groups. Duration and severity of anemia and effects of exchange transfusion on the ESSm-VCFc relationship were determined. RESULTS: The SCA patients had increased LV dimensions in systole and diastole, and increased indexed LV mass. Load-dependent measurements of LV function (ETc, %FS, and VCFc) were lower in SCA patients, and afterload, as measured by ESSm, was increased. The ESSm-VCFc relationship demonstrated reduced contractility in SCA patients compared with control subjects. Degree and duration of anemia along with exchange transfusions did not impact contractility. CONCLUSIONS: Sickle cell anemia patients have significant LV dilatation and increased LV mass due to abnormal loading conditions. Contractility, measured by the ESSm-VCFc index, is lower in SCA patients and was not negatively impacted by severity or duration of anemia, or exchange transfusions. The underlying mechanism explaining these findings requires further investigation. |
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Authors:
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Luke Lamers; Greg Ensing; Ricardo Pignatelli; Caren Goldberg; Louis Bezold; Nancy Ayres; Robert Gajarski |
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Publication Detail:
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Type: Journal Article Date: 2006-05-15 |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 47 ISSN: 1558-3597 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2006 Jun |
Date Detail:
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Created Date: 2006-06-05 Completed Date: 2006-06-27 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 2283-8 Citation Subset: AIM; IM |
Affiliation:
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Division of Pediatric Cardiology, C. S. Mott Children's Hospital, University of Michigan, Ann Arbor, Michigan, USA. llamers@chw.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent African Americans Anemia, Sickle Cell / blood, physiopathology*, ultrasonography Case-Control Studies Child Child, Preschool Echocardiography Female Humans Infant Male Myocardial Contraction* Myofibrils* Prospective Studies Severity of Illness Index Systole* Time Factors Ventricular Function Ventricular Function, Left* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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