Left atrial dysfunction in sickle cell anemia is associated with diffuse myocardial fibrosis, increased right ventricular pressure and reduced exercise capacity
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Why the study?
LA dysfunction and stiffness contribute to diastolic heart failure in other settings, but their associations with ECV, TRV, and exercise abnormalities in sickle cell anemia remained unexamined.
Design
Prospective study
Authors
Discussion
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Implication
Associates left atrial stiffness with fibrosis and RV pressure in sickle cell anemia; hypothesis-generating for its role in exercise limitation.
Structured PICO
P
Population
24 children and adults with sickle cell anemia (homozygous HbSS), median age 20 years (range 7-61), 54% female, US-based. Key exclusion criteria: chronic transfusion therapy and glomerular filtration rate <60 mL/min/1.73 m2.
O
Outcome
Associations between left atrial (LA) stiffness and extracellular volume (ECV), tricuspid regurgitation jet velocity (TRV), and exercise capacity (%predicted VO2)surrogate
In patients with sickle cell anemia, left atrial stiffness is significantly associated with diffuse myocardial fibrosis, increased right ventricular pressure, and reduced exercise capacity.
Limitations
- Small sample size
- Wide age range (6-60 years)
- Short axis post contrast views of the LA were not acquired and quantitative assessment of LA LGE was not possible
- Cannot determine if LA stiffness is secondary to LV fibrosis-related DD, LA fibrosis, or both
Cite This Study
Alsaied et al. (2020) studied this question.
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