title: Left ventricular systolic function in sickle cell anemia: a meta-analysis.
abstract: BACKGROUND
  We sought to evaluate whether patients with sickle cell anemia (SCA) have left ventricular (LV) systolic dysfunction.
  
  
  RESULTS
  We conducted a Medline, Embase, Ebscohost, and Google scholar literature search articles published before April 2010. All studies that compared any measure of LV function (eg, ejection fraction [EF], fractional shortening [FS], or cardiac index [CI]) between normal control subjects and SCA (hemoglobin SS) patients were included. Among 57 studies that qualified for review, 19 studies including 841 SCA patients and 554 control subjects met the inclusion criteria. There were no significant differences in either LVEF (Hedge g = 0.15; 95% confidence interval -0.84 to 1.14; P = .76) or FS (P = .28) between SCA patients and control subjects. CI was significantly higher (P < .001) and LV end-systolic stress-volume index (load independent) was significantly lower (P < .001) in SCA patients. All LV systolic measures inversely correlated with age (all P < .001). LV end-systolic and -diastolic dimensions were significantly higher in SCA patients and increased with age.
  
  
  CONCLUSIONS
  SCA patients have similar load-dependent but lower load-independent measures of LV systolic function than control subjects. SCA is associated with LV dilation. LV structural and functional abnormalities appear to be age dependent with progressive LV dilation and impairment over time.
authors.affiliation: Division of Cardiovascular Medicine, Department of Medicine, State University of New York, Downstate Medical Center, Brooklyn, New York, USA.
authors.forename: Shyam
authors.initials: S
authors.lastname: Poludasu
authors.forename: Keshwar
authors.initials: K
authors.lastname: Ramkissoon
authors.forename: Louis
authors.initials: L
authors.lastname: Salciccioli
authors.forename: Haroon
authors.initials: H
authors.lastname: Kamran
authors.forename: Jason M
authors.initials: JM
authors.lastname: Lazar
mesh_terms: D000367:Age Factors; D000755:Anemia, Sickle Cell / Q000503:physiopathology*; D002302:Cardiac Output / Q000502:physiology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000503:physiopathology; D013599:Systole / Q000502:physiology*; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology*