Altered left ventricular twist is associated with clinical severity in adults and adolescents with homozygous sickle cell anemia.

Autor:	Braga JC; Echocardiography Department, Dante Pazzanese Institute of Cardiology, São Paulo, Brazil. Electronic address: joaocbraga2002@yahoo.com.br., Assef JE; Cardiovascular Imaging Department, Dante Pazzanese Institute of Cardiology, São Paulo, Brazil., Waib PH; Internal Medicine Department, Marilia Medical School (Famema), Marilia, Brazil., de Sousa AG; Invasive Cardiology Department, Dante Pazzanese Institute of Cardiology, São Paulo, Brazil., de Mattos Barretto RB; Echocardiography Department, Dante Pazzanese Institute of Cardiology, São Paulo, Brazil., Guimarães Filho FV; Cardiology Department, Marilia Medical School (Famema), Marilia, Brazil., Rodrigues A; Cardiology Department, Marilia Medical School (Famema), Marilia, Brazil., Vilela FD; Cardiology Department, Marilia Medical School (Famema), Marilia, Brazil., de Castro Bienert IR; Cardiology Department, Marilia Medical School (Famema), Marilia, Brazil., Tan DM; Hematology Department, Marilia Medical School (Famema), Marilia, Brazil., Peluccio DC; Hematology Department, Marilia Medical School (Famema), Marilia, Brazil.
Jazyk:	angličtina
Zdroj:	Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography [J Am Soc Echocardiogr] 2015 Jun; Vol. 28 (6), pp. 692-9. Date of Electronic Publication: 2015 Feb 25.
DOI:	10.1016/j.echo.2015.01.019
Abstrakt:	Background: Sickle cell anemia (SCA) is associated with cardiac abnormalities and premature death. The aims of this study were to identify early markers of cardiac dysfunction through ventricular strain and ventricular twist and determine the relationships between these measures and other markers of cardiovascular risk. Methods: Forty patients with SCA (mean age, 23.5 ± 9.3 years; 24 male patients) and 40 age- and sex-matched healthy individuals were compared. All subjects participated in structured interviews, and blood samples were collected. Standard echocardiography with subsequent offline evaluations using left ventricular (LV) and right ventricular systolic strain and rotational analyses of the left ventricle using two-dimensional speckle-tracking echocardiography were performed. Results: There were no differences in LV ejection fraction, global LV strain (longitudinal, circumferential, and radial), and global right ventricular longitudinal strain between patients and controls; however, LV twist was significantly lower in the patient group (mean, 7.4 ± 1.2° vs 10.7 ± 1.8°; P < .0001). Several variables were strongly related to LV twist, including the clinical severity index (ρ = -0.97, Z score = -6.05, P < .0001), E/e' ratio (r = 0.78, P < .0001), LV end-diastolic volume index (r = 0.81, P < .0001), and pulmonary artery systolic pressure (r = 0.72, P < .0001). Conclusions: LV twist is altered in patients with SCA. There were strong correlations between left ventricular twist and clinical severity index, E/e' ratio, LV end-diastolic volume index, and pulmonary artery systolic pressure. These data suggest that decreased LV twist may indicate a subgroup of patients with SCA at greater cardiac risk. (Copyright © 2015 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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