title: Echocardiographic evaluation of left ventricular diastolic and systolic function in Saudi patients with sickle cell disease.
abstract: OBJECTIVE
  Sickle cell disease (SCD) is a chronic, inherited haemoglobin disorder, associated with recurrent vaso-occlusive and haemolytic crises and chronic tissue ischemia which may adversely affect any organ system. Our objectives were to evaluate the left ventricular (LV) systolic and diastolic functions in Saudi patients with SCD originally from the Eastern Province of Saudi Arabia.
  
  
  METHODS
  Prospective hospital based echocardiography study on adolescent and adult patients with SCD.
  
  
  METHODS
  Forty-five patients with SCD were recruited for echocardiographic study while 45 patients, matched for age and sex, served as controls. Left and right ventricular dimensions and LV wall thicknesses, LV mass index (LVMI) and LV contractility variables were obtained. Left atrial dimension and volume and pulmonary artery systolic pressure (PASP) were also estimated. We also evaluated parameters of LV diastolic function, including early and late mitral flow velocities (E and A wave respectively), E/A ratio, deceleration time (MVDT), A wave duration (MVA D), LV isovolumic relaxation time (IVRT), and tissue Doppler velocities, such as lateral annular e' wave, a' wave, e'/a' ratio and E/e' ratio.
  
  
  RESULTS
  There were increases in the LV dimensions, LV volumes, stroke volume, and LVMI of the SCD patients. The preload was increased (LV diastolic volume) and afterload was decreased (low diastolic blood pressure). The LVEF was equivalent, though there was evidence of LV diastolic dysfunction in 24%, and pulmonary hypertension (PH) in 40% of the SCD patients. The mean left atrial volume (LAV) was also increased in the SCD patients.
  
  
  CONCLUSIONS
  LV diastolic dysfunction (heart failure with preserved ejection fraction) and PH may complicate cases of the Arab-Indian haplotype of SCD.
authors.affiliation: University of Dammam and King Fahd Hospital of the University, Dammam, PO Box 40032, Alkhobar 31952.
authors.forename: Mohammed Fakhry
authors.initials: MF
authors.lastname: Abdul-Mohsen
keywords: E/A, E wave/A wave ratio; E/e‘, mitral flow E wave velocity/lateral annular e‘ wave velocity by TDI; Lat a‘, lateral annular a‘ wave velocity by TDI (cm. sec); Lat e‘, lateral annular e‘ wave velocity by TDI (cm. sec); Left ventricular diastolic function; Left ventricular systolic function; MVA vel, mitral valve flow A wave velocity (cm. sec); MVAD, mitral valve A wave duration (ms); MVDT, mitral valve deceleration time (ms); MVE vel, mitral valve flow E wave velocity (cm. sec); Sickle cell disease; TDI, tissue doppler imaging; Tissue doppler imaging; e‘/a‘, e‘ wave/a‘ wave ratio