Evaluation of Cardiac Sequelae in Patients with Sickle Cell Anemia

Introduction: The aim of this study was aim to evaluate cardiac function by means of echocardiography in patients with sickle cell anemia. Methods: This was a case control study that evaluated a total of 44 patients with sickle cell anemia, who were on regular follow up, and 44 age/sex-matched normal healthy control subjects. M-mode, two-dimensional, Doppler and pulse tissue-Doppler echocardiographic measurements were performed in both groups. Results: The mean age was 14.06 +/- 6.4 years (55% female, 45% male). The mean hemoglobin, hemoglobin F, and serum ferritin levels were 9.4 +/- 1.20 g/dL, 22.7 +/- 12.9 g/dL, and 391 +/- 590 ng/dL respectively. Pulsed Doppler echocardiography showed that the early diastolic trans-tricuspid peak flow velocity was greater in the patients than in the control subjects. Assessment of the lateral mitral and tricuspid annulus peak velocities by pulsed tissue Doppler imaging showed that the patients had significantly greater systolic, and early and late diastolic velocities than the controls. The left ventricular diameter, interventricular septum diameter, and posterior wall diameter were statistically significantly greater in the patients compared with the control group, whereas there was no difference in ejection fraction. Conclusion: Sickle cell anemia in children results in a volume-overloaded heart with a significant increase in left ventricular dimensions. However, left ventricular systolic dysfunction and pulmonary hypertension were not frequent findings in our patients.