Evaluation of left ventricular systolic function in children with sickle cell anemia: contribution of 2D strain

Background: Cardiovascular involvement is not well studied in children with sickle cell disease. The aim of this study was to evaluate the echocardiographic parameters and to investigate speckle tracking echocardiography (STE) interest in detecting subclinical myocardial impairment of children with sickle cell disease. Methods: The study was directed in the echocardiographic laboratory in the military hospital of Tunis between July 2018 and December 2018. 30 patients with sickle cell anemia (SCA) and 30 controls were compared. The echocardiographic measurements were indexed according to body surface. Cardiac output, left ventricular ejection fraction, wall thickness, as well as LV 2-D longitudinal systolic strain were assessed. Results: The SCA Group included 30 patients (11.8 ± 2yrs, sex ratio: 1.31) with homozygous SCA and the C Group included 30 healthy controls (12.7 ± 1,2yrs, sex ratio: 1.27). According to the findings, SCA Group showed significantly larger LV diameter (36.2±2.5mm/m2 vs 29.3±1.3mm/m2, p=0.005). SCA Group also showed lower LV ejection fraction (62%±0.5 vs 65%±5, p=0.001). No significant difference was observed for cardiac output (p=0.4). Otherwise, two-dimensional longitudinal strain of LV was higher in SCA group (-21%±3.07 vs -25%±2.98; p<0.01). Conclusions: Our study highlights several cardiac abnormalities in children with SCA, which could represent a marker of disease severity and point out the importance of the cardiologic screening of these patients.