Author + information
- Received June 4, 1990
- Revision received December 26, 1990
- Accepted January 17, 1991
- Published online June 1, 1991.
- Jannet F. Lewis, MD, FACC∗,a,
- Barry J. Maron, MD, FACC∗,a,
- Oswaldo Castro, MDa and
- Yunus A. Moosa, MDa
- ↵∗Address for reprints: Jannet F. Lewis, MD, Howard University Hospital, 2041 Georgia Avenue. Northwest (Room 6C-11). Washington. D.C. 20060.
To determine whether left ventricular diastolic abnormalities are an early feature of sickle cell anemia, indexes of diastolic filling were obtained with pulsed Doppler echocardiography in 30 consecutive patients with this disease (mean age 29 years; range 19 to 39) who had not experienced symptoms of heart failure and had normal left ventricular systolic function. Data were compared with those in 30 normal control subjects of similar ages.
Seventeen (57%) of the 30 patients with sickle cell, anemia had evidence of abnormal left ventricular diastolic filling. Six of these 17 patients had a Doppler pattern consistent with “restrictive” filling, characterized by reduced early diastolic deceleration time (<110 ms) or an increased rate of decline of early flow velocity (EF slope >7.4 m/s2), or both, as well as decreased late diastolic velocity-time integral (2.6 ± 0.7 vs. 3.4 ± 0.8 cm in normal subjects: p < 0.05). Another 11 patients showed a Doppler waveform consistent with impaired relaxation, characterized by prolonged deceleration time (>166 ms) or reduced EF slope (<3.8 m/s2), as well as increased late diastolic velocity-time integral 14.0 ± 0.5 vs. 3.4 ± 0.8 cm in normal subjects; p = 0.03).
This Doppler echorardiographic analysis demonstrates that left ventricular diastolic filling patterns are altered in patients with sickle cell anemia and that these diastolic abnormalities may be present in the absence of symptoms of heart failure. These abnormal patterns suggest an intrinsic myocardial abnormality in patients with sickle anemia and may prove to be early markers of cardiac disease.
☆ This study was supported in part by Grant HL01984 from the National institutes of Health, Bethesda, Maryland.
- Received June 4, 1990.
- Revision received December 26, 1990.
- Accepted January 17, 1991.