scholarly journals Effect of Haematocrit on Left Ventricular Dimensions and Systolic Function in Children with Sickle Cell Anaemia: A Comparative Study

Author(s):  
Chika Onyinyechi Duru ◽  
Timipah Peregba West ◽  
Josephat M. Chinawa ◽  
Olukemi O. Ige ◽  
Fidelia Bode-Thomas

This was a comparative cross-sectional study where the left ventricular dimensions and functional parameters of 41 children (aged 1 to 18 years) with sickle cell anaemia were compared with those of 52 age-and-sex matched HbAA controls using transthoracic echocardiography. Majority of the left ventricular dimensions were significantly larger in the study group than the controls (p<0.05). The mean indices for left ventricular systolic function were higher in the study group than the controls though not statistically significant (p>0.05). Left ventricular dimensions correlated positively with age and body surface area in both groups (p<0.05) but inversely with haematocrit in the study group especially the left ventricular internal diameters in diastole and systole and left ventricular mass (p=0.001). Although 14.6% - 59.5% of the changes in cardiac dimensions were attributable to age, haematocrit level and body surface area in the study group (p<0.05), most of this effect was due to haematocrit.

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
David A McNamara ◽  
Ari Bennett ◽  
Jarett D Berry ◽  
Mark S Link

Introduction: Recent studies have shown an association between early repolarization pattern (ERP) ECG morphology and sudden cardiac death. The role of left ventricular mass (LVM) as a potential mediator of ERP has not been well explored. Methods: Participants in the Dallas Heart Study who underwent an ECG and cardiac MRI (CMR) were assessed for ERP, defined as J-point elevation ≥1 mm in any 2 contiguous leads. We compared participants with and without ERP by age, gender, race/ethnicity, established cardiovascular risk factors of diabetes, hypertension and hyperlipidemia, lean body mass and percent body fat, and CMR-derived LVM, LVM/body surface area, and LVH defined by standard criteria, using Student’s T-tests and chi-squared tests where appropriate. Results: Of the 3,015 participants in our study, 276 (9.2%) had ERP. Participants with ERP were younger (43±9 vs 44±10 yrs, p=0.04), more prevalent in blacks than non-blacks (14 vs 5.0%, p<0.00001), and in men than women (18 vs 2.0%, p<0.00001). Baseline cardiovascular risk factors were not significantly different. Participants with ERP demonstrated higher lean body mass (59±10 vs 52±11 kg, p<0.00001) and lower percent body fat (27±8 vs 36±9%, p<0.00001). The presence of ERP was associated with greater LVM, increased LVM/body surface area, and the presence of LVH in the overall population and in analyses stratified by sex (Table 1). Conclusion: In a large, multi-ethnic cohort, ERP is associated with increased total LVM, increased LVM/body surface area, and LVH. These novel associations may provide insight into the biology of ERP. Further studies investigating the relationship of LVM and LVH with ERP are warranted.


Hypertension ◽  
2020 ◽  
Vol 76 (2) ◽  
pp. 514-522 ◽  
Author(s):  
Coral Garcia-Gonzalez ◽  
Georgios Georgiopoulos ◽  
Samira Abdel Azim ◽  
Fernando Macaya ◽  
Nikos Kametas ◽  
...  

Preeclampsia at term accounts for half of maternal deaths from hypertensive disorders. We aimed to assess differences in maternal cardiac indices at 35 +0 to 36 +6 weeks’ gestation between women who subsequently developed preeclampsia at term compared with those with uncomplicated pregnancy and to evaluate whether cardiac indices offer incremental prognostic value to the available screening algorithm for preeclampsia. We recruited 1602 women with singleton pregnancies who attended for a routine hospital visit at 35 +0 to 36 +6 weeks’ gestation between April and November 2018. We recorded maternal characteristics and preeclampsia-risk-score derived from a competing risks model and measured cardiac indices. Preeclampsia developed in 3.12% (50/1602) of participants. Women with preeclampsia, compared with those without, had increased mean arterial pressure (97.6, SD, 5.53 versus 87.9, SD, 6.82 mm Hg), systemic vascular resistance (1500, interquartile range, 1393–1831 versus 1400, interquartile range, 1202–1630 PRU) and preeclampsia-risk-score (23.4, interquartile range, 9.13–40 versus 0.9, interquartile range, 0.32–3.25). Multivariable analysis demonstrated independent association between the incidence of preeclampsia and E/e′ (hazard ratio, 1.19/unit [95% CI, 1.03–1.37]; P =0.018) as well as left ventricular mass indexed for body surface area (hazard ratio, 1.03/[g·m 2 ] [95% CI, 1.003–1.051]; P =0.029). Women with E/e′ ≥7.3 and left ventricular mass indexed for body surface area ≥63.2 g/m 2 had an increased risk for developing preeclampsia, despite low preeclampsia-risk-score <5% (hazard ratio, 20.1 [95% CI, 10.5–38.7], P <0.001). Increased left ventricular mass and E/e′ offer incremental information to available scoring systems and better stratify women at risk of developing preeclampsia at term.


2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
T Miyoshi ◽  
K Addetia ◽  
A Blitz ◽  
R Lang ◽  
F Asch

Abstract Funding Acknowledgements WASE Normal Values Study is sponsored by American Society Echocardiography Foundation. OnBehalf the WASE Investigators Background The American Society of Echocardiography (ASE) and the European Association of Cardiovascular Imaging (EACVI) chamber quantification guidelines provide normal reference values for a variety of size and function parameters. While used worldwide, these were predominantly obtained from American and European Caucasian populations and may not represent individuals from other regions around the world. Accordingly, ASE in collaboration with its International Alliance Partners conducted the World Alliance of Societies of Echocardiography (WASE) Normal Values Study to establish and compare normal echocardiographic values across races, ethnicities and countries worldwide. While most previous studies focused on left ventricular (LV) size and ejection fraction, LV stroke volume (SV) in healthy normal subjects has not been well defined. In this report, we aim to examine similarities and differences in normal LV SV indexed by body surface area (SVI) among regions around the world. Methods WASE Normal Values Study is a multinational, observational, cross-sectional study. Individuals free from known cardiac, lung and renal disease were prospectively enrolled with even distribution among age groups and gender. Echocardiographic images were acquired following a standardized protocol. LV SV was assessed by Doppler-derived (LVOT diameter and VTI) and two-dimensional (2D) biplane Simpson’s methods. LV SVI was calculated to account for differences in body size. These measurements were analyzed (TOMTEC) in a single core laboratory following ASE/EACVI Guidelines. Results As of May 2019, LV SV has been analyzed in 1164 cases from 13 countries, representing 8 distinct regions worldwide. In this population, age, body surface area and 2D LV ejection fraction were 47 ± 17 years old (range 18-87 years old), 1.76 ± 0.22 m² (range 0.95-2.44 m²) and 63.2 ± 2.9 % (range 52.7-73.7 %), respectively. LV SV and SVI by Doppler were larger than those obtained by 2D method in all regions. LV SV and SVI in both methods had significant differences among regions (p&lt; 0.0001, Kruskal-Wallis test). LV SV and SVI in South Asia (India) were smallest in both methods and were also significantly smaller than other Asian regions (Figure). North America and Europe had largest LV SV and SVI by Doppler method, while Oceania had largest values by 2D. Conclusions The WASE Normal Values Study shows geographical variability in LV SVI across continents and countries. This information should be considered when determining normative values for SV and SVI. Abstract P1766 Figure.


2015 ◽  
Vol 17 (2) ◽  
pp. 160 ◽  
Author(s):  
Fujian Duan ◽  
Zhi Qi ◽  
Sheng Liu ◽  
Xiuzhang Lu ◽  
Hao Wang ◽  
...  

Aims: The graft of stem cells to treat ischemic cardiomyopathy is popular in many clinical trials. The aim of this study was to evaluate the effectiveness of isolated coronary artery bypass graft combined with bone marrow mononuclear cells (BMMNC) delivered through graft vessels to improve left ventricular remodeling of patients with previous myocardial infarc- tion and chronic heart failure using echocardiography. Material and methods: Patients with previous myocardial infarction and chronic heart failure were randomly allocated to one of the two groups: CABG only (18 patients), or CABG with BMMNC transplantation (24 patients). Echocardiographic parameters were measured on B-mode imaging, 3D imaging and color flow imaging. Results Post-operative LVEDD (end-diastolic dimension of left ventricle), LVESD (end-systolic dimension of left ventricle), LVEDV (end-diastolic volume of left ventricle), LVESV (end-systolic volume of left ventricle), LVEDVI (LVEDV indexed to body surface area), LVESVI (LVESV indexed to body surface area), LV-mass (mass of left ventricle) and LV- massI (LV-mass indexed to body surface area) were significantly improved compared with those obtained prior to operation in CABG+BMMNC group (al p0.05). Postoperative mitral regurgitation score was not significantly different from those prior to opera- tion in both groups (al p>0.05). In Chi-square tests, LVEDD, LVESD, LVEDV, LVESV, LVEDVI, LVESVI, LV-mass, LV- massI were determinants of the left ventricular remodeling. Conclusion: The improvement of left ventricular remodeling in CABG+BMMNC group was better than in the CABG group and this improvement was verified by echocardiography.


2012 ◽  
Vol 23 (5) ◽  
pp. 727-737 ◽  
Author(s):  
Sudhir K. Mehta

AbstractBackgroundRecent evidence in adults suggests that left ventricular mass measured as left ventricular mass/height1.7 predicts cardiovascular morbidity and mortality better than the two widely used indices, left ventricular mass/body surface area and left ventricular mass/height2.7. Standards of left ventricular mass/height1.7 have not been reported in children, for whom, owing to lack of significant cardiovascular morbidity and mortality, body mass index has traditionally been used as a potential cardiovascular risk factor.MethodsIn this retrospective study, 692 clinically normal children aged 1 day to 18 years underwent detailed echocardiographic assessment to assess whether any of the left ventricular mass indices – left ventricular mass/height1.7, left ventricular mass/body surface area, and left ventricular mass/height2.7 – are associated with obesity as measured by body mass index. Correlations, t-tests, and linear regressions were used for statistical testing.ResultsLeft ventricular mass/height1.7 was better correlated (R2 = 0.36) with body mass index than left ventricular mass/body surface area (R2 = 0.179) and left ventricular mass/height2.7 (R2 = 0.006), although all three dependent variables show a significant correlation (p < 0.035). In addition, a higher percentage of obese patients were noted to have elevated left ventricular mass as measured by left ventricular mass/height1.7 than by the other two methods.ConclusionsLeft ventricular mass/height1.7 is a reliable indicator of obesity-associated left ventricular hypertrophy. Left ventricular mass/height1.7 can be used conveniently during transitions from youth to adults for long-term follow-up. These findings support the importance of including left ventricular mass/height1.7 in future studies of cardiovascular risks and preventive strategies in children and adolescents.


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