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Left ventricular hypertrophy and diastolic dysfunction in children with sickle cell disease are related to asleep and waking oxygen desaturation

Left ventricular hypertrophy and diastolic dysfunction in children with sickle cell disease are related to asleep and waking oxygen desaturation
Left ventricular hypertrophy and diastolic dysfunction in children with sickle cell disease are related to asleep and waking oxygen desaturation

Premature death and cardiac abnormalities are described in individuals with sickle cell disease (SCD), but the mechanisms are not well characterized. We tested the hypothesis that cardiac abnormalities in children with SCD are related to sleep-disordered breathing. We enrolled 44 children with SCD (mean age, 10.1 years; range, 4-18 years) in an observational study. Standard and tissue Doppler echocardiography, waking oxygen saturation averaged over 5 minutes, and overnight polysomnography were obtained in participants, each within 7 days. Eccentric left ventricular (LV) hypertrophy was present in 46% of our cohort. After multivariable adjustment, LV mass index was inversely related to average asleep and waking oxygen saturation. For every 1% drop in the average asleep oxygen saturation, there was a 2.1 g/m2.7 increase in LV mass index. LV diastolic dysfunction, as measured by the E/E′ ratio, was present in our subjects and was also associated with low oxygen saturation (sleep or waking). Elevated tricuspid regurgitant velocity (≥ 2.5 m/sec), a measure of pulmonary hypertension, was not predicted by either oxygen saturation or sleep variables with multivariable logistic regression analysis. These data provide evidence that low asleep and waking oxygen saturations are associated with LV abnormalities in children with SCD.

0006-4971
16-21
Johnson, Mark C.
32e46f56-0232-45f3-a8ed-5a2896965c9f
Kirkham, Fenella J.
1dfbc0d5-aebe-4439-9fb2-dac6503bcd58
Redline, Susan
3466f7f2-aa34-4c87-b8f1-37e039f6f0bd
Rosen, Carol L.
3a8d9aa4-397d-47f6-8791-3df3e42eb1a5
Yan, Yan
29c1b391-21ad-465e-b4d6-3220430fdb9f
Roberts, Irene
6e025a6a-755f-4340-9a45-a99b0fde116b
Gruenwald, Jeanine
feef3cbb-93db-4033-a187-20c75393103f
Marek, Jan
3a130470-e134-4b12-af2b-ebf1e217c09f
DeBaun, Michael R.
76559153-80c6-4642-bdf8-672a75570dfe
Johnson, Mark C.
32e46f56-0232-45f3-a8ed-5a2896965c9f
Kirkham, Fenella J.
1dfbc0d5-aebe-4439-9fb2-dac6503bcd58
Redline, Susan
3466f7f2-aa34-4c87-b8f1-37e039f6f0bd
Rosen, Carol L.
3a8d9aa4-397d-47f6-8791-3df3e42eb1a5
Yan, Yan
29c1b391-21ad-465e-b4d6-3220430fdb9f
Roberts, Irene
6e025a6a-755f-4340-9a45-a99b0fde116b
Gruenwald, Jeanine
feef3cbb-93db-4033-a187-20c75393103f
Marek, Jan
3a130470-e134-4b12-af2b-ebf1e217c09f
DeBaun, Michael R.
76559153-80c6-4642-bdf8-672a75570dfe

Johnson, Mark C., Kirkham, Fenella J., Redline, Susan, Rosen, Carol L., Yan, Yan, Roberts, Irene, Gruenwald, Jeanine, Marek, Jan and DeBaun, Michael R. (2010) Left ventricular hypertrophy and diastolic dysfunction in children with sickle cell disease are related to asleep and waking oxygen desaturation. Blood, 116 (1), 16-21. (doi:10.1182/blood-2009-06-227447).

Record type: Article

Abstract

Premature death and cardiac abnormalities are described in individuals with sickle cell disease (SCD), but the mechanisms are not well characterized. We tested the hypothesis that cardiac abnormalities in children with SCD are related to sleep-disordered breathing. We enrolled 44 children with SCD (mean age, 10.1 years; range, 4-18 years) in an observational study. Standard and tissue Doppler echocardiography, waking oxygen saturation averaged over 5 minutes, and overnight polysomnography were obtained in participants, each within 7 days. Eccentric left ventricular (LV) hypertrophy was present in 46% of our cohort. After multivariable adjustment, LV mass index was inversely related to average asleep and waking oxygen saturation. For every 1% drop in the average asleep oxygen saturation, there was a 2.1 g/m2.7 increase in LV mass index. LV diastolic dysfunction, as measured by the E/E′ ratio, was present in our subjects and was also associated with low oxygen saturation (sleep or waking). Elevated tricuspid regurgitant velocity (≥ 2.5 m/sec), a measure of pulmonary hypertension, was not predicted by either oxygen saturation or sleep variables with multivariable logistic regression analysis. These data provide evidence that low asleep and waking oxygen saturations are associated with LV abnormalities in children with SCD.

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Published date: 8 July 2010

Identifiers

Local EPrints ID: 429376
URI: http://eprints.soton.ac.uk/id/eprint/429376
ISSN: 0006-4971
PURE UUID: 48442645-2dc6-4c04-950e-530a494d90da
ORCID for Fenella J. Kirkham: ORCID iD orcid.org/0000-0002-2443-7958

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Date deposited: 26 Mar 2019 17:30
Last modified: 30 Jan 2020 01:31

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Contributors

Author: Mark C. Johnson
Author: Fenella J. Kirkham ORCID iD
Author: Susan Redline
Author: Carol L. Rosen
Author: Yan Yan
Author: Irene Roberts
Author: Jeanine Gruenwald
Author: Jan Marek
Author: Michael R. DeBaun

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