Tissue Doppler Imaging-derived Diastolic Function Assessment in Children With Sickle Cell Disease and Its Relation With Ferritin.
Diastolic dysfunction has been shown to occur earlier than systolic dysfunction in iron overload states in adult patients with sickle cell disease (SCD). Tissue Doppler imaging (TDI)-derived E/E' has emerged as a noninvasive marker of diastolic function. We sought to determine diastolic function in children with SCD and study its relation with iron overload. A retrospective review of medical records of 225 pediatric patients with SCD who received an echocardiogram between January 2008 and December 2012 was performed. Echocardiographic measures including M-mode, spectral Doppler, and TDI-derived E/E' were compared with previously published data in healthy children. The left ventricular end-diastolic and end-systolic dimensions were significantly higher in SCD (P<0.0001) and the shortening fraction was similar (P=0.66). E/E' ratio was significantly higher in SCD at the mitral annulus, septum, and tricuspid annulus. In 54% of subjects, the septal E/E' was >8, indicating elevated left ventricular filling pressure. However, there was no significant correlation between ferritin level and E/E' ratios. Pediatric patients with SCD have a high prevalence of elevated estimated left ventricular filling pressure, but this does not correlate with ferritin levels.
*Department of Pediatrics †Sibley Heart Center Cardiology ‡Division of Hematology-Oncology, Children's Healthcare of Atlanta and Emory University School of Medicine, Atlanta, GA.
Michelle
M
Olson
Camden
C
Hebson
Alexandra
A
Ehrlich
Tamara
T
New
Ritu
R
Sachdeva
D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging; D002648:Child; D003971:Diastole; D015150:Echocardiography, Doppler; D005260:Female; D005293:Ferritins / Q000097:blood*; D006801:Humans; D019190:Iron Overload / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging; D008297:Male; D012189:Retrospective Studies; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology
D005293:Ferritins