Subclinical Cardiac Dysfunction Is Associated With Extracardiac Organ Damages
| Autor: | Blaise Felix Faye, Youssouf Traore, Gaëlle Legueun, Samuel Kingue, Brigitte Ranque, Aissata Tolo, Lucile Offredo, Aymeric Menet, Kouakou Boidy, Moussa Seck, David Chelo, Indou Deme-Ly, Eli Cochise Abough, Guillaume Wamba, Ibrahima Bara Diop, Ibrahima Diagne, Ibrahima Sanogo, Sylvestre Maréchaux, Mamadou Diarra, Dapa A. Diallo, Xavier Jouven, Saliou Diop, Roland N'Guetta, Mariana Mirabel, Cheick Oumar Diakite, Gustave Koffi, Ismael Kamara |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Cardiac output Diastole heart failure global health 030204 cardiovascular system & hematology Left ventricular hypertrophy 03 medical and health sciences 0302 clinical medicine Internal medicine hemic and lymphatic diseases medicine 030212 general & internal medicine cardiovascular diseases Stroke hemolytic anemia Original Research Subclinical infection lcsh:R5-920 Ejection fraction business.industry General Medicine medicine.disease medicine.anatomical_structure Heart failure Cardiology Vascular resistance cardiovascular system Medicine sickle cell disease cardiac remodeling business lcsh:Medicine (General) |
| Zdroj: | Frontiers in Medicine, Vol 5 (2018) Frontiers in Medicine |
| Popis: | Background: Several studies conducted in America or Europe have described major cardiac remodeling and diastolic dysfunction in patients with sickle cell disease (SCD). We aimed at assessing cardiac involvement in SCD in sub-Saharan Africa where SCD is the most prevalent. Methods: In Cameroon, Mali and Senegal, SCD patients and healthy controls of the CADRE study underwent transthoracic echocardiography if aged ≥10 years. The comparison of clinical and echocardiographic features between patients and controls, and the associations between echocardiographic features and the vascular complications of SCD were assessed. Results: 612 SCD patients (483 SS or Sβ0, 99 SC, and 19 Sβ+) and 149 controls were included. The prevalence of dyspnea and congestive heart failure was low and did not differ significantly between patients and controls. While left ventricular ejection fraction did not differ between controls and patients, left and right cardiac chambers were homogeneously more dilated and hypertrophic in patients compared to controls and systemic vascular resistances were lower (p < 0.001 for all comparisons). Three hundred and forty nine SCD patients had extra-cardiac organ damages (stroke, leg ulcer, priapism, microalbuminuria or osteonecrosis). Increased left ventricular mass index, cardiac dilatation, cardiac output, and decreased systemic vascular resistances were associated with a history of at least one SCD-related organ damage after adjustment for confounders. Conclusions: Cardiac dilatation, cardiac output, left ventricular hypertrophy, and systemic vascular resistance are associated with extracardiac SCD complications in patients from sub-Saharan Africa despite a low prevalence of clinical heart failure. The prognostic value of cardiac subclinical involvement in SCD patients deserves further studies. |
| Databáze: | OpenAIRE |
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