Tissue Doppler Imaging–derived Diastolic Function Assessment in Children With Sickle Cell Disease and Its Relation With Ferritin. Issue 1 (January 2016)

• Record Type: Journal Article
• Authors: Olson, Michelle; Hebson, Camden; Ehrlich, Alexandra; New, Tamara; Sachdeva, Ritu
• Is Part Of: Journal of pediatric hematology/oncology. Volume 38:Issue 1(2016)
• Publication Date: 2016-01
• Subjects: sickle cell disease -- echocardiography -- tissue Doppler -- iron -- ferritin; Pediatric hematology -- Periodicals; Tumors in children -- Periodicals; 618.9215
• DOI: 10.1097/MPH.0000000000000430
• Languages: English
• ISSNs: 1077-4114

Abstract

Abstract : Diastolic dysfunction has been shown to occur earlier than systolic dysfunction in iron overload states in adult patients with sickle cell disease (SCD). Tissue Doppler imaging (TDI)-derived E/E′ has emerged as a noninvasive marker of diastolic function. We sought to determine diastolic function in children with SCD and study its relation with iron overload. A retrospective review of medical records of 225 pediatric patients with SCD who received an echocardiogram between January 2008 and December 2012 was performed. Echocardiographic measures including M-mode, spectral Doppler, and TDI-derived E/E′ were compared with previously published data in healthy children. The left ventricular end-diastolic and end-systolic dimensions were significantly higher in SCD ( P <0.0001) and the shortening fraction was similar ( P =0.66). E/E′ ratio was significantly higher in SCD at the mitral annulus, septum, and tricuspid annulus. In 54% of subjects, the septal E/E′ was >8, indicating elevated left ventricular filling pressure. However, there was no significant correlation between ferritin level and E/E′ ratios. Pediatric patients with SCD have a high prevalence of elevated estimated left ventricular filling pressure, but this does not correlate with ferritin levels.