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Cardiac manifestations in sickle cell disease varies with patient genotype

Title: Cardiac manifestations in sickle cell disease varies with patient genotype
Authors: Guedeney, Paul; Lionnet, François; Ceccaldi, Alexandre; Stankovic Stojanovic, Katia; Cohen, Ariel; Mattioni, Sarah; Montalescot, Gilles; Bachmeyer, Claude; Isnard, Richard; Haymann, Jean‐Philippe; Hammoudi, Nadjib
Source: British Journal of Haematology ; volume 181, issue 5, page 664-671 ; ISSN 0007-1048 1365-2141
Publisher Information: Wiley
Publication Year: 2018
Collection: Wiley Online Library (Open Access Articles via Crossref)
Description: Summary Cardiac involvement is well characterized in sickle cell anaemia ( SCA ) but cardiac features associated with Haemoglobin SC (Hb SC ) disease are mostly unknown. We compared 60 patients with Hb SC disease (median age 31 years, 25 men) to 60 SCA patients and 60 controls matched for age and gender. Left ventricular ejection fraction ( LVEF ), left ventricle ( LV ) mass index ( LVM i), cardiac index and peak tricuspid regurgitation velocity ( TRV ) were measured using echocardiography. LV filling pressures were assessed using the ratio of early diastolic transmitral velocity to tissue velocity (E/e’ ratio). The LVM i was higher in both genotypes compared to controls. However, whereas LV hypertrophy was observed only in 3(5%) Hb SC patients, this condition was diagnosed in 27(45%) SCA patients ( P < 0·0001). While cardiac index and TRV were similar in Hb SC compared to controls, SCA patients exhibited elevated cardiac output and TRV . LVEF was similar in the 3 groups. However, both genotypes had a higher E/e’ ratio compared to controls. Cardiac involvement in SCA was related to anaemia and haemolysis, while LV diastolic dysfunction and TRV in Hb SC disease patients were related to arterial hypertension and overweight comorbidities. In summary, cardiac involvement and its determinants are different in Hb SC disease and SCA . Patient's genotype should be considered with regard to the echocardiographic indications and findings.
Document Type: article in journal/newspaper
Language: English
DOI: 10.1111/bjh.15238
Availability: https://doi.org/10.1111/bjh.15238; https://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1111%2Fbjh.15238; https://onlinelibrary.wiley.com/doi/pdf/10.1111/bjh.15238
Rights: http://onlinelibrary.wiley.com/termsAndConditions#vor
Accession Number: edsbas.AAE5580E
Database: BASE