076: Left atrial enlargement in sickle cell disease patients: remodelling associated with haematological parameters or index of left ventricular filling pressures

Abstract

Diastolic Left ventricular (LV) dysfunction is a common finding in sickle cell disease. Furthermore, left atrial (LA) size usually reflects left ventricular filling pressures. The aim of our study was to determine if LA size is an expression of left ventricular filling pressures or reflects remodelling associated with anemia and/or haemolysis in sickle cell disease. We evaluated 127 patients with sickle cell disease in stable condition (mean age 28,6±8,5 years, 83 women) and 38 age and sex-matched healthy controls. LA size was measured with Simpson's method in apical 4-chamber view. LV filling pressures were assessed using ratio between pulsed Doppler peak E velocity and peak Ea velocity obtained with tissue Doppler imaging of the lateral annulus (E/Ea ratio). Clinical and biologic data were collected from clinical records. Compared with the normal group, patients with sickle cell disease had a LA volume and E/Ea ratio significatively increased (48,4±11,2 ml/m 2 ; and 5,9±1,7; 30,5±7,6 ml/m&sup2; and 4,5±1, respectively, p<0.0001). In multivariate analysis, LA enlargement in patients is only influenced by age and haematological parameters (haemoglobin and reticulocyte levels). No correlation was found between LA volume and E/Ea ratio (figure). Subjects with sickle cell disease have LA enlargement. However, in this population, LA dilatation is not an index of left ventricular filling pressures. Figure