Diastolic Dysfunction Is an Independent Risk Factor for Death in Patients With Sickle Cell Disease
Key result
Diastolic dysfunction linked to ~3.5-fold higher mortality in sickle cell disease.
- RR 3.5
- 95% CI 1.5 to 8.4
- P<0.001
- n=235
Why the study?
The prevalence of diastolic dysfunction, its association with pulmonary hypertension, and its impact on mortality in patients with sickle cell disease were unknown.
Population
235 patients with sickle cell disease
Comparison
Patients with diastolic dysfunction vs without diastolic dysfunction
Design
Cohort study with echocardiographic assessment
Authors
Discussion
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Implication
Cohort study reveals diastolic dysfunction independently predicts mortality in sickle cell disease, indicating the need for routine echocardiographic screening.
Key Points
- To characterize left ventricular diastolic function in adult patients with sickle cell disease and evaluate its relationship with pulmonary hypertension and prospective mortality.
- Evaluated conventional echocardiographic parameters of diastolic function in 235 adult patients with sickle cell disease.
- Performed tissue Doppler imaging in a subgroup of 141 patients to assess diastolic dysfunction and tricuspid regurgitation jet velocity.
- Diastolic dysfunction was identified in 18% of patients, and 11% presented with both diastolic dysfunction and pulmonary hypertension.
- Diastolic dysfunction was independently associated with mortality with a risk ratio of 3.5 (95% CI, 1.5 to 8.4; p < 0.001) after adjusting for tricuspid regurgitation jet velocity.
- The co-occurrence of diastolic dysfunction and pulmonary hypertension conferred a risk ratio for death of 12.0 (95% CI, 3.8 to 38.1; p < 0.001).
Study Design
Type
Cohort (n=235)
PICO
P
Population
235 adult patients with sickle cell disease evaluated for left ventricular diastolic function and pulmonary hypertension to assess prospective mortality risk.
E
Exposure / Comparator
Diastolic dysfunction vs Normal diastolic function
O
Primary Outcome
Mortality — RR 3.5 (1.5 to 8.4), p=< 0.001
Main Result
Relative Risk: 3.5 (95% CI 1.5–8.4)
p-value: p=< 0.001
Cite This Study
Sachdev et al. (2007) conducted a cohort in Sickle cell disease (n=235). Diastolic dysfunction vs. Normal diastolic function was evaluated on Mortality (RR 3.5, 95% CI 1.5 to 8.4, p=< 0.001). Diastolic dysfunction was independently associated with mortality in patients with sickle cell disease (RR 3.5; 95% CI 1.5 to 8.4; p < 0.001).