title: Assessment of ventricular function in adults with sickle cell disease: role of two-dimensional speckle-tracking strain.
abstract: BACKGROUND
  Sickle cell disease (SCD) is a hemoglobinopathy that is common worldwide. It usually presents with cardiac involvement, although data on systolic function are somewhat controversial. The aim of this study was to investigate the value of speckle-tracking strain, a deformation index, in detecting ventricular dysfunction in SCD.
  
  
  METHODS
  Ninety adult patients with SCD were compared with 20 healthy controls. Doppler echocardiography with Doppler tissue imaging was performed in all, and the left and right ventricles were analyzed by the use of two-dimensional speckle-tracking strain.
  
  
  RESULTS
  The mean age of the patients with SCD was 26 years, and 43% were men. Left ventricular (LV) dimensions and mass were higher in patients with SCD, whereas LV ejection fraction did not differ from the controls. E and A waves, as well as E/e' ratio, were also higher in patients with SCD. Two-dimensional speckle-tracking strain of both ventricles in the patients with SCD was not different from that of controls. The factors independently associated with LV longitudinal strain were age (P = .009), oximetry (P = .001), lactate dehydrogenase (P = .014), LV ejection fraction (P < .001), and right ventricular systolic annular velocity (P = .010).
  
  
  CONCLUSIONS
  Ventricular enlargement with normal ventricular function was a frequent finding in SCD. Two-dimensional speckle-tracking strain of both ventricles was similar in patients and controls, suggesting normal myocardial contractility in patients with SCD. LV global longitudinal strain was associated with age, intensity of hemolysis, and ventricular function.
authors.affiliation: Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; Ecocenter, Socor Hospital, Belo Horizonte, Brazil. Electronic address: marciambarbosa@terra.com.br.
authors.forename: Marcia M
authors.initials: MM
authors.lastname: Barbosa
authors.affiliation: Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Maria Carmen M
authors.initials: MC
authors.lastname: Vasconcelos
authors.affiliation: Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Teresa Cristina A
authors.initials: TC
authors.lastname: Ferrari
authors.affiliation: Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Bárbara Martins
authors.initials: BM
authors.lastname: Fernandes
authors.affiliation: Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Luiz Guilherme
authors.initials: LG
authors.lastname: Passaglia
authors.affiliation: Fundação Centro de Hematologia e Hemoterapia de Minas Gerais (Hemominas Foundation), Belo Horizonte, Brazil.
authors.forename: Célia Maria
authors.initials: CM
authors.lastname: Silva
authors.affiliation: Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Maria Carmo P
authors.initials: MC
authors.lastname: Nunes
mesh_terms: D000328:Adult; D000755:Anemia, Sickle Cell / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D004452:Echocardiography / Q000379:methods*; D055119:Elastic Modulus; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D033081:Shear Strength; D013314:Stress, Mechanical; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology*; D055815:Young Adult
keywords: Echocardiography; Sickle cell disease; Two-dimensional speckle-tracking strain; Ventricular function