Real Time 3-D Echocardiography for Evaluation of Left Ventricle in Children

Abstract

Background: Cardiovascular events and complications are the leading causes of mortality and morbidity in patients with sickle cell anemia (SCA) . Early identification of ventricular dysfunction, before the appearance of symptoms, can alter the prognosis by optimizing therapy. This study aimed at clarifying the value of Real Time 3D Echocardiography (RT3DE ) in early detection of regional myocardial dysfunction in those patients before the development of overt cardiomyopathy. Methods: This is an observational cross sectional study that was carried out on 60 children divided into 2 groups; Group 1 included 30 children with SCA, Group 2: 30 children matched for age and sex as a control group. For all children: ethically committee approval and informed consent from the parents or their guardians was obtained. All Children with SCA under the age of 15 who do not show any signs or symptoms of heart failure were included in this study . Any child with present or past history of heart failure or any child with associated congenital or acquired heart diseases was excluded from the study. All children with systemic diseases that may affect cardiac structure and function have been also excluded. All the children were subjected to through clinical evaluation for any signs of heart failure, Echocardiography studies , included M mode , Tissue Doppler and 4D echo for assessment of left ventricle. Statistical analysis : IBM SPSS statistics was used for data analysis. Data were expressed as Mean ±SD. t test was used for differences in the variables between patients and control . Pearson correlation test was used for possible association between each two variables. Statistical significance was defined as a p value < 0.05. Results: TDI showed left ventricular systolic and diastolic dysfunction in SCA compared with the control. RT3DE was a sensitive tool to detect an increase in LVEF . There was no significant LV enlargement through LV LSS and DSI in our cohort. There was no significant relation between hemoglobin level and different echo parameters in the studied groups. Conclusion : RT3DE with tissue Doppler technique are promising tools for early detection of regional systolic or diastolic dysfunction of left ventricle in children with SCA.