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Assessing the atria in pediatric sickle cell disease: Beyond the dilation.
Loar, Robert W; George, Alex; Varghese, Nidhy P; Liu, Asela M; Colquitt, John L; Pignatelli, Ricardo H.
Afiliação
  • Loar RW; Pediatric Cardiology, Cook Children's Medical Center, Fort Worth, TX, USA.
  • George A; Pediatric Hematology/Oncology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
  • Varghese NP; Pediatric Pulmonology and Pulmonary Hypertension, Baylor College of Medicine/Texas Children's Hospital, Houston, TX, USA.
  • Liu AM; Pediatric Cardiology, Baylor College of Medicine/Texas Children's Hospital, Houston, TX, USA.
  • Colquitt JL; Pediatric Cardiology, Baylor College of Medicine/Texas Children's Hospital, Houston, TX, USA.
  • Pignatelli RH; Pediatric Cardiology, Baylor College of Medicine/Texas Children's Hospital, Houston, TX, USA.
Echocardiography ; 38(2): 189-196, 2021 02.
Article em En | MEDLINE | ID: mdl-33336441
ABSTRACT

BACKGROUND:

Diastolic dysfunction (DD) and pulmonary hypertension (PH) are common causes of mortality for sickle cell disease (SCD) patients in developed countries. We hypothesized that left and right atrial strain (LAS-Ɛ, RAS-rƐ) are decreased in SCD adolescents, and that worsening values correlate with laboratory markers of disease severity.

METHODS:

Prospective cohort study of patients with HbSS genotype of SCD was compared with healthy controls. LAS and RAS were measured from 4- and 2-chamber views by a blinded reader. Peak strain and strain rate values were obtained for atrial contraction (ac), reservoir (res), and conduit (con) phases. Mitral/tricuspid Doppler velocities, left atrial volume, right atrial area were obtained. Laboratory variables were obtained from the electronic record with the three prior values being averaged. Differences in variables were assessed with Wilcoxon rank sum test, and correlations assessed with Spearman's coefficient.

RESULTS:

There were 33 SCD patients compared to 35 healthy controls of similar age, gender, and size. SCD patients had increased left atrial volume and right atrial area. For LAS, Ɛres was significantly lower in SCD patients. For RAS, RƐcon was significantly lower. Neither measurement correlated with clinical markers. The majority of SCD patients had relatively normal atrial strain values. Those with markedly lower values had similar atrial size.

CONCLUSIONS:

A sub-set of SCD patients have markedly low Ɛres and rƐcon. No correlation with clinical markers was identified. Larger, longitudinal studies may determine utility of atrial strain as a screening tool in this at-risk population.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Disfunção Ventricular Esquerda / Anemia Falciforme Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Child / Humans Idioma: En Revista: Echocardiography Assunto da revista: CARDIOLOGIA / DIAGNOSTICO POR IMAGEM Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Disfunção Ventricular Esquerda / Anemia Falciforme Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Child / Humans Idioma: En Revista: Echocardiography Assunto da revista: CARDIOLOGIA / DIAGNOSTICO POR IMAGEM Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Estados Unidos