Myocardial perfusion in children with sickle cell anaemia.
BACKGROUND
Myocardial ischaemia is an unexpected complication with potentially serious clinical damages in patients with sickle cell anaemia (SCA). Conventional techniques, such as exercise testing and echocardiography, have low sensitivity and specificity for the detection of myocardial ischaemia in patients with SCA.


OBJECTIVE
To assess myocardial perfusion using thallium-201 (201Tl) single-photon emission computed tomography (SPECT) in children with SCA.


METHODS
Eight patients (11.5 +/- 5.0 years, mean +/- SD) who were free of cardiac symptoms were studied. Myocardial perfusion was assessed by 201Tl-SPECT after stress and 3 h later after a further injection. Left ventricular ejection fraction (LVEF) was assessed by equilibrium radionuclide angiography.


RESULTS
Myocardial perfusion was abnormal in three of eight patients: two had reversible defects and one had a fixed defect. The mean LVEF was 53 +/- 8%. There was no relationship between myocardial perfusion and LVEF.


CONCLUSIONS
Treatment of asymptomatic myocardial ischaemia remains unclear, and more aggressive therapy of the haematological disease should be considered.
Acar
P
P
Service de Cardiologie Pédiatrique, Hôpital Necker-Enfants Malades, Paris, France.
Sébahoun
S
S
de Pontual
L
L
Maunoury
C
C
D000293:Adolescent; D000328:Adult; D000755:Anemia, Sickle Cell / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D003326:Coronary Circulation; D005080:Exercise Test; D005260:Female; D015637:Gated Blood-Pool Imaging; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D012720:Severity of Illness Index; D013318:Stroke Volume; D013794:Thallium Radioisotopes / Q000008:administration & dosage; D015899:Tomography, Emission-Computed, Single-Photon
D013794:Thallium Radioisotopes