Tissue Doppler Echocardiographic Findings of Left Ventricle in Children with Sickle-Cell Anemia

BACKGROUND Sickle-cell disease (SCD) is an inherited hemoglobin childhood disorder, frequently complicated by pulmonary hypertension and cardiac involvement. Cardiovascular events and complications are the leading cause of mortality and morbidity in patients with SCD. Tissue Doppler imaging and the myocardial performance index (Tei index), are simple indices for the assessment of the cardiac function. The purpose of this study was to assess the left ventricular function in children with SCD. METHODS Sixty-four patients with SCD (mean age = 11.7 ± 5.5 years) were compared with 50 age-matched healthy controls (mean age = 11.2 ± 5.20 years). Myocardial wall motion velocities at the lateral mitral annulus and the junction between the medial mitral annulus and the interventricular septum were assessed during systole (Sa), early diastole (Ea), and late diastole (Aa) through a four-chamber view using pulsed Doppler echocardiography. The ejection fraction and shortening fraction were estimated. The Tei index was estimated via tissue Doppler echocardiography. RESULTS The results showed that Ea and Aa velocity in the mitral annulus and interventricular septum had no difference between the patients and controls (p value > 0.05), and nor was there any difference between the two groups as regards the Tei index, Ea/Aa, ejection fraction, and shortening fraction (p value > 0.05). Sa(m) wave velocity, however, had a significant difference between the two groups (p value < 0.038). CONCLUSION The Tei index is a sensitive indicator for the cardiac function in chronic diseases and the right ventricular function in some disorders such as SCD.