Evaluation of left ventricular function in patients with sickle cell anemia

Gerry, Joseph L.; Baird, Michael G.; Fortuin, Nicholas J.

doi:10.1016/0002-9343(76)90568-4

Cited by 89 publications

(58 citation statements)

References 21 publications

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“…In the subgroup of patients with SCD and TRV ‡2AE5 m/s we found a tendency towards a dilatation of the left ventricle at follow-up, in accordance with previous studies (Gerry et al, 1976;Balfour et al, 1984;Dham et al, 2009).…”

Section: Discussionsupporting

confidence: 92%

Pulmonary hypertension in sickle cell disease children under 10 years of age

et al. 2010

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SummaryDespite the finding of elevated Tricuspid Regurgitant Velocity (TRV) in children below 5 years of age, the prevalence and evolution of Pulmonary Hypertension (PH) in young children with sickle cell disease (SCD) are unclear. In order to identify predictive factors of precocious PH development, SCD children ‡3 years old, at steady state, underwent annual echocardiography and Tissue Doppler Imaging (TDI). Patients receiving chronic transfusion were excluded. Thirty-seven of seventy-five patients were ‡3 years, with measurable TRV. In our young population (mean age 6AE2 years) of mainly African, HbS/HbS patients, 8/37 (21AE6%) had TRV ‡2AE5 m/s, 8% being only 3 years old. Significant correlation was found between precocious TRV elevation and high platelet and reticulocyte counts and frequent acute chest syndromes (ACS). In multivariate analysis, ACS was the only variable predicting TRV ‡2AE5 m/s. TDI of the 37 patients showed signs of diastolic dysfunction of the left ventricle. At follow-up all eight patients with high TRV displayed further increase and seven more developed TRV ‡2AE5 m/s. PH seems to begin in children earlier than expected. Factors involved in its early onset might be different from the ones causing its development in older children or adults. African children might benefit from early screening and re-assessment once a year.

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Section: Discussionsupporting

confidence: 92%

Pulmonary hypertension in sickle cell disease children under 10 years of age

et al. 2010

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“…This was expected, as sickle cell disease has been shown to behave like chronic anemias of other causes which cause cardiac enlargement via an increase in cardiac output [17][18][19]. The difference in the prevalence of cardiomegaly between the young and old age groups can be explained by the long-term hemodynamic effects of long-standing high output.…”

Section: Cardiomegalymentioning

confidence: 93%

The older sickle cell patient

2004

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The lifespan of sickle cell patients has increased substantially. We chose to compare the attributes of older sickle cell patients with younger ones within the confines of a single institutional study serving the local Bronx population. Laboratory and clinical assessments from 40 patients with sickle cell disease over 40 years of age were compared to 40 patients under 30 years of age. When the older group was compared to the younger group, hemoglobin, indirect bilirubin, and platelet counts were significantly lower. Creatinine clearances were lower and BUN levels were higher in the older group. Although the prevalence of radiographically measured cardiomegaly was significantly higher in the older group, systolic and diastolic blood pressures remained unchanged. The number of crises and number of admissions were higher in the younger group than in the older, but there was wide variation, and no significant differences could be detected; days spent in hospital over the previous 2 years did not differ. No statistically significant differences were observed for absolute reticulocyte count, MCV, % HbF, white cell count, liver function tests, or oxygen saturation. Comparing genders within age groups, younger males had higher hemoglobin levels and absolute reticulocyte counts than younger females, while only the older females had higher HbF levels than the corresponding males. Lower levels of hemoglobin associated with older age may reflect decreased hematopoietic potential that may in part be due to decreased renal function. Lower platelet counts in older sickle cell patients may be a consequence of this decreased hematopoietic potential but may also represent a secondary survival benefit effect in sickle cell anemia. Am.

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“…Physiologically, chronic anaemia leads to an increased cardiac output (CO) as a result of decreased afterload, an increase in preload and an increase in chronotropic/ inotropic effects. This will eventually lead to ventricular dilation and LVH [42][43][44] . This chronic rise in CO eventually causes remodeling of the central elastic arteries of aorta or carotids.…”

Section: Anaemiamentioning

confidence: 99%

Cardiovascular co-morbidity in chronic kidney disease: Current knowledge and future research needs

Alani

Tamimi

2014

WJN

101

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Chronic kidney disease (CKD) is recognised as a health concern globally and leads to high rates of morbidity, mortality and healthcare expenditure. CKD is itself an independent risk factor for unfavorable health outcomes that include cardiovascular disease (CVD). Coronary artery disease is the primary type of CVD in CKD patients and a significant cause of death among renal transplant patients. Traditional and non-traditional risk factors for CVD exist in patients with CKD. Traditional factors include smoking, hypertension, dyslipidemia and diabetes which are highly prevalent in CKD patients. Non-traditional risk factors of CKD are mainly uraemiaspecific and increase in prevalence as kidney function declines. Some examples of uraemia-specific risk factors that have been well documented include low levels of haemoglobin, albuminuria, and abnormal bone and mineral metabolism. Therapeutic interventions targeted at more traditional risk factors which contribute to CVD, have not had the desired effect on lowering CVD events and mortality in those suffering with CKD. Future research is warranted to delineate clear evidence to the benefit of modifying non-traditional risk factors. Key words: Cardiovascular disease; Chronic kidney disease; Risk factors; InflammationCore tip: Chronic kidney disease (CKD) has been recognised as a health concern globally and leads to high morbidity, mortality and healthcare expenditure. CKD is an independent risk factor for several different unfavourable outcomes including cardiovascular disease (CVD). Traditional and non-traditional risk factors for CVD exist in patients with CKD. Non-traditional risk factors of CKD are mainly uraemia-specific and include release of large levels of inflammatory and prothrombotic factors, low levels of haemoglobin, albuminuria, and abnormal bone and mineral metabolism. Future research is warranted to delineate clear evidence to the benefit of modifying non-traditional risk factors Alani H, Tamimi A, Tamimi N. Cardiovascular co-morbidity in chronic kidney disease: Current knowledge and future research needs. World J Nephrol 2014; 3(4): 156-168 Available from:

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Evaluation of left ventricular function in patients with sickle cell anemia

Cited by 89 publications

References 21 publications

Pulmonary hypertension in sickle cell disease children under 10 years of age

Pulmonary hypertension in sickle cell disease children under 10 years of age

The older sickle cell patient

Cardiovascular co-morbidity in chronic kidney disease: Current knowledge and future research needs

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