Left ventricular global longitudinal strain and acute myocardial injury in patients with sickle cell disease admitted to the intensive care unit for vaso-occlusive crisis

Br J Haematol. 2024 May;204(5):2007-2015. doi: 10.1111/bjh.19394. Epub 2024 Mar 12.

Abstract

In patients with sickle cell disease (SCD), SCD-related cardiomyopathy may be partly due to repeated ischaemic events related to sickling during vaso-occlusive crises, but few clinical studies support this hypothesis. We evaluated the incidence of acute myocardial ischaemia during vaso-occlusive crises as assessed by the left ventricular global longitudinal strain (LVGLS) and high-sensitive cardiac troponin T (hs-cTnT). We included adult patients with SCD admitted to the intensive care unit (ICU) for vaso-occlusive crisis. We collected hs-cTnT and measured LVGLS with echocardiography at admission (day 1), day 2, day 3 and ICU discharge. Among 55 patients included, considering only the first hospitalization of patients admitted several times, 3 (5%) had elevated hs-cTnT at ≥1 time point of the ICU stay. It was ≤2 times the upper limit of normal in two of these patients. LVGLS was altered at ≥1 time point of the ICU stay in 13 (24%) patients. Both hs-cTnT and LVGLS were abnormal at ≥1 time point of the hospital stay in 2 (4%) patients. Acute myocardial injury as assessed by troponin elevation and LVGLS impairment was a rare event during vaso-occlusive crises.

Keywords: acute chest syndrome; cardiac strain; haemoglobinopathy; myocardial ischaemia; sickle cell anaemia.

MeSH terms

  • Adult
  • Anemia, Sickle Cell* / blood
  • Anemia, Sickle Cell* / complications
  • Echocardiography
  • Female
  • Global Longitudinal Strain
  • Humans
  • Intensive Care Units*
  • Male
  • Middle Aged
  • Myocardial Ischemia / blood
  • Myocardial Ischemia / etiology
  • Troponin T* / blood

Substances

  • Troponin T