Gated myocardial perfusion scintigraphy in children with sickle cell anemia: correlation with echocardiography

Rev Esp Med Nucl. 2011 Nov-Dec;30(6):354-9. doi: 10.1016/j.remn.2011.02.003. Epub 2011 Mar 31.
[Article in English, Spanish]

Abstract

Objectives: The heart is one of the organs affected by sickle cell anemia (SCA). This prospective study has aimed to evaluate myocardial perfusion and left ventricle (LV) function in children with SCA by gated myocardial perfusion scintigraphy (G-MPS) and to compare the results with echocardiographic parameters.

Methods: Forty-three patients with SCA were evaluated by G-MPS and echocardiography. Myocardial perfusion and motion with thickening function were analyzed both visually and quantitatively. End-diastolic (EDV), end-systolic volumes (ESV), ejection fraction (EF), lung-to-heart (L/H) ratio were also calculated.

Results: None of the patients showed stress perfusion impairment in G-MPS. LV dilatation in 15 patients was observed both by G-MPS and echocardiography. EF values were within normal limits. Correlation between EF values calculated by two methods was not statistically significant. However, LV dilatation detected by both methods and EDV-ESV values in G-MPS were correlated to end-diastolic and end-systolic diameters calculated in echocardiography (p<0.05). M-Mode echocardiography revealed higher myocardial performance index (LV-MPI) in patients with LV dilatation. There was also a significant relationship between LV dilatation and frequent blood transfusions (>5/years) and acute chest syndrome (p<0.05).

Conclusion: Myocardial perfusion impairment in children with SCA is not frequently observed. Thus, performing the scintigraphy only in patients with cardiac symptoms should be considered. Since EF values of the children with SCA are not deteriorated in early stages, LV-MPI and LV dilatation should be considered as a significant parameter other than EF or perfusion data.

MeSH terms

  • Adolescent
  • Anemia, Sickle Cell / drug therapy
  • Anemia, Sickle Cell / physiopathology*
  • Benzoates / therapeutic use
  • Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography / methods*
  • Chelation Therapy
  • Child
  • Deferasirox
  • Dilatation, Pathologic / diagnostic imaging
  • Dipyridamole
  • Echocardiography, Stress
  • Female
  • Heart Ventricles / diagnostic imaging
  • Humans
  • Hydroxyurea / therapeutic use
  • Iron Chelating Agents / therapeutic use
  • Iron Overload / chemically induced
  • Iron Overload / drug therapy
  • Male
  • Myocardial Perfusion Imaging / methods*
  • Prospective Studies
  • Stroke Volume
  • Transfusion Reaction
  • Triazoles / therapeutic use
  • Vasodilator Agents
  • Ventricular Dysfunction, Left / diagnostic imaging*
  • Ventricular Dysfunction, Left / etiology

Substances

  • Benzoates
  • Iron Chelating Agents
  • Triazoles
  • Vasodilator Agents
  • Dipyridamole
  • Deferasirox
  • Hydroxyurea