Hemodynamic and ECG Responses to Exercise in Children With Sickle Cell Anemia

Transient Left Ventricular Dysfunction in Childhood Sickle Cell Disease

“…Our patient showed no electrocardiographic or perfusion abnormali- ties during maximal exercise study after recovery from his acute illness. Electrocardiographic changes suggesting myocardial ischemia are common in sickle cell children during exercise and correlate with the degree of anemia [1,3,10].…”

“…Coronary artery dilation and the absence of significant atherosclerotic disease, along with left ventricular enlargement and hypertrophy, have been consistent autopsy findings in adult sickle cell disease patients [2,4,9], irregardless of the presence or absence of myocardial infarct. Some have suggested that acute derangements of myocardial substrate supply versus demand may result in ischemia in the absence of thrombosis [1,3,10].…”

Hemoglobin Levels Predict Exercise Performance, ST‐Segment Depression, and Outcome in Patients Referred for Routine Exercise Treadmill Testing

“…6,7 Children with low levels of hemoglobin have been shown to have worse exercise performance and changes on ECG consistent with ischemia. 8,9 Additionally, correction of anemia in patients with heart failure or chronic kidney disease has been shown to improve exercise performance 10 -12 and reduce the magnitude of ST-segment depression that develops during exercise testing. 13 Additionally, hemoglobin has been shown to be a significant predictor of mortality in elderly patients, 14 in patients referred for coronary angiography, 15,16 and in patients with acute coronary syndromes.…”

Introduction: Pediatric Cardiology Exercise Testing

“…Unfortunately, as pointed out Pediatr Cardiol 20: [1][2][3]1999 Pediatric Cardiology especially in the articles by Wessel [30] and Paul and Wessel [24], the nonuniformity of exercise protocols makes the interpretation and comparison of studies difficult. Wessel goes so far as to recommend a database for children with heart disease similar to the one developed for children with cystic fibrosis.…”

“…In 1974, Godfrey [15], in England, wrote the first textbook devoted to exercise testing of children. In the mid-and latter 1970s and early 1980s Strong and colleagues at the Medical College of Georgia [3,4,23,[27][28][29], and James [18] at Cincinnati Children's Hospital published normative data for both black children and white children that included blood pressure and electrocardiographic measurements. Both preferred the cycle ergometer because it reduced the amount of noise and made the blood pressure easier to measure.…”