Abnormalities in Cardiac Structure and Function in Adults with Sickle Cell Disease are not Associated with Pulmonary Hypertension

作者：Knight Perry Jessica E; de las Fuentes Lisa; Waggoner Alan D; Hoffmann Raymond G; Blinder Morey A; Davila Roman Victor G; Field Joshua J^*

来源：Journal of the American Society of Echocardiography, 2011, 24(11): 1285-1290.

DOI：10.1016/j.echo.2011.07.009

• Pulmonary hypertension
• Diastolic dysfunction
• Sickle cell disease

Background: In sickle cell disease (SCD), pulmonary hypertension (assessed by tricuspid regurgitant jet [TRJ] velocity >= 2.5 m/sec) is associated with increased mortality. The relationships among TRJ velocity and left ventricular (LV) and right ventricular (RV) systolic and diastolic i.e., relaxation and compliance) have not been well characterized in SCD.
Methods: A prospective study was conducted in 53 ambulatory adults with SCD (mean age, 34 years; range, 21-65 years) and 33 African American controls to define the relationship between LV and RV function and TRJ velocity using echocardiography.
Results: Subjects with SCD had larger left and right atrial volumes and increased LV mass compared with controls. When patients with SCD were compared with controls, LV and RV relaxation (i.e., E') were similar. Among subjects with SCD, pulmonary hypertension (TRJ >= 2.5 m/sec) was present in 40%. Higher TRJ velocity was correlated with larger left atrial volumes in patients with SCD. Additionally, some measures of LV (peak A, lateral and septal annular E/E' ratio) and RV (tricuspid valve E/E' ratio) compliance were correlated with TRJ velocity. No other measures of LV and RV systolic function or LV diastolic i.e., relaxation and compliance) were associated with TRJ velocity.
Conclusions: Ambulatory adults with SCD exhibited structural (i.e., LV and RV chamber enlargement) and functional (i.e., higher surrogate measures of LV and RV filling pressure) abnormalities compared with the control group. In subjects with SCD, few abnormalities of LV and RV structure and function were associated with TRJ velocity. (J Am Soc Echocardiogr 2011; 24: 1285-90.)

• 出版日期2011-11