title: Left ventricular dyssynchrony is an early manifestation of heart involvement in sickle cell anemia.
abstract: BACKGROUND
  Sickle cell anemia (SCA) is the most common inherited anemia. Although heart involvement in SCA is well-established, there is no data about changes of contraction synchrony in SCA. Therefore, we aimed to study the left ventricular contraction synchrony in SCA patients with narrow QRS and normal ejection fraction (EF).
  
  
  METHODS
  Thirty-six patients with SCA and 37 age- and gender-matched control subjects were included in the study. Left ventricular dyssynchrony was investigated by color-coded tissue Doppler imaging.
  
  
  RESULTS
  The SCA patients had lower hemoglobin (Hb) and higher ferritin, left ventricular end-diastolic diameter, left ventricular end-systolic diameter, left ventricular mass index (LVMI), and pulmonary artery pressure. Peak A velocity, Dt, and E/E' values were higher in the SCA group however, E/A ratio and average Em were higher in the control group. LV systolic dyssynchrony parameters including Ts-SD-12, Ts-12, Ts-SD-6, and Ts-6 were found to be higher in SCA group when compared with controls. In addition to that, the patients with ventricular dyssynchrony (a Ts-SD-12 > 34.4 msec) were higher in the SCA group than the control group (55.6% vs. 8.1%, P < 0.001). In the correlation analysis, systolic dyssynchrony parameters were found to be correlated with Hb, ferritin, LVMI, E/A, Dt, Em.
  
  
  CONCLUSIONS
  Our results revealed that in SCA patients with normal EF and narrow QRS, left ventricular systolic dyssynchrony was an early manifestation of heart involvement and might be coexisted with or preceding diastolic dysfunction.
authors.affiliation: Department of Cardiology, Tayfur Ata Sokmen Medical School, Mustafa Kemal University, Hatay, Turkey. mfkarakas@hotmail.com
authors.forename: Mehmet Fatih
authors.initials: MF
authors.lastname: Karakaş
authors.forename: Eyüp
authors.initials: E
authors.lastname: Büyükkaya
authors.forename: Mustafa
authors.initials: M
authors.lastname: Kurt
authors.forename: Murat
authors.initials: M
authors.lastname: Çelik
authors.forename: Esra
authors.initials: E
authors.lastname: Karakaş
authors.forename: Sule
authors.initials: S
authors.lastname: Büyükkaya
authors.forename: Adnan Burak
authors.initials: AB
authors.lastname: Akçay
authors.forename: Nihat
authors.initials: N
authors.lastname: Sen
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000755:Anemia, Sickle Cell / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D016022:Case-Control Studies; D015897:Comorbidity; D018618:Echocardiography, Doppler, Color / Q000379:methods; D018619:Echocardiography, Doppler, Pulsed / Q000379:methods*; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D011237:Predictive Value of Tests; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D013318:Stroke Volume / Q000502:physiology*; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000503:physiopathology; D055815:Young Adult