Assessment of left ventricular systolic function in children with iron deficiency anemia by two-dimentional echocardiography and tissue Doppler in Beni- Suef university hospital

Document Type : Original Article

Authors

1 Pediatrics department, Faculty of Medicine, Beni-Suef University, Egypt

2 Cardiology department ,Faculty of medicine, Beni-suef University,Egypt

Abstract

Cardiac structure and function in iron deficiency anemia  are mainly affected by two competing factors: iron deficiency  and increased cardiac output (CO). Anaemia and iron deficiency (ID)  are common causes of heart failure, both separately and in combination.The goal of this study is to assess the systolic function of left ventricle in  ( IDA )using tissue doppler in pediatrics . Sixty (60) children  grouped into two groups,one with IDA and another control group. All candidates were suspected to history taking, full clinical examination ,complete blood count  ,iron profile and echocardiographic examination. There was significant difference between cases and controls regarding peak systolic velocity across mitral annulus (SM) using tissue doppler imaging . There was no significant difference in left ventricle  (LV) dimentions between cases and controls, The mean value of LVESV   in case group was 2.0 ± .28 cm while it was 2.1 ± .3  cm in  control P value was (.64) . There was no correlation between HB level or ferritin level and SM or EFThe study revealed preserved LV systolic functions as detected by conventional echocardiography however tissue Doppler imaging technique had shown latent LV systolic dysfunction Further follow up is needed for cases to assess reversability of finding .

Keywords

Main Subjects

References

  1. Kassebaum NJ, Jasrasaria R, Naghavi M, Wulf SK, Johns N, Lozano R, et al .A systematic analysis of global anemia burden from 1990 to 2010. Blood. 2014;123(5):615–24.
  2. Pasricha SR,Drakesmith H,Black J, Hipgrave D, Biggs BA. control of iron deficiency anemia in low-and middle-income countries.Blood.2013;121(14):2607-17.
  3. Lopez A, Cacoub P, Macdougall IC, Peyrin-Biroulet L. Iron deficiency anaemia. Lancet 2016; 387: 907-16.
  4. Hegde N, Rich MW, Gayomali C The cardiomyopathy of iron deficiency. Tex Heart Inst J,2006 33:340–344.
  5. Martijn F. Hoes , Niels Grote Beverborg, J. David Kijlstra, Jeroen Kuipers , DorineW. Swinkels , Ben N.G. Giepmans  et al  Iron deficiency impairs contractility of human cardiomyocytes through decreased mitochondrial function, European Journal of Heart Failure,2018; 20, 910–919.
  6. Baker RD, Greer FR Committee on Nutrition American Academy of Pediatrics. Diagnosis and prevention of iron deficiency and iron-deficiency anemia in infants and young children (0-3 years of age). Pediatrics 2010 ;126(5):1040-1050.
  7. Lang RM, Badano LP, Mor‑Avi V, Afilalo J, Armstrong A, Ernande L et al . Recommendations for cardiac chamber quantification by echocardiography in adults: An update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 2015;28:1‑39.e14.
  8. Zhou Q ,  Jiaqi Shen, Yue Liu, Runlan Luo, Bijun Tan, Guangsen Li  . Assessment of left ventricular systolic function in patients with iron deficiency anemia by three-dimensional speckle-tracking echocardiography. Anatol J Cardiol.2017 :18(3):194-9
  9. Komajda M, Anker SD, Charlesworth A, Okonko D, Metra M, Di Lenarda A,et al . The impact of new onset anaemia on morbidity and mortality inchronic heart failure: results from COMET. Eur Heart J 2006 ;27(12):1440–6.
  10. Kaitha S, Bashir M, Ali T. Iron deficiency anemia in inflammatory bowel disease. World J Gastrointest Pathophysiol. 2015;6(3):62–72.
  11. Yu C.M,  Sanderson J.E,  Marwick T.H, et al.  Tissue Doppler imaging a new prognosticator for cardiovascular diseases, J. Am. Coll. Cardiol 2007,49(19): 1903-1914.
  12. Garadah, Taysir S.; Kassab, Salah; Mahdi, Najat; Abu-Taleb, Ahmed; Jamsheer, Anwer :  Pulsed and tissue Doppler echocardiographic changes in patients with thalassemia major clinical medicine insights. Cardiology,2010; 3: 1-8.
  13. Juliana Xavier-Ferrucio , Vanessa Scanlon , Xiuqi Li, Ping-Xia Zhang , Larisa Lozovatsky, Nadia Ayala-Lopez , et al. Low iron promotes megakar- yocytic commitment of megakaryocytic-erythroid progenitors in humans and mice. Blood. 2019;134(18):1547-1557
  14. Batur G K , Ali B H , Meral U M , Gokhan G , Bulent M .  Medicine Science International Medical Journal ,  Evaluation of left ventricular functions before and after iron therapy in patients  with iron deficiency anemia.2019  10.5455/medscience.;08.9054
  15. Cho IJ, Mun YC, Kwon KH, Shin GJ . Effect of anemia correction on left ventricular structure and filling pressure in anemic patients without overt heart disease. Korean J Intern Med 2014 ; 29: 445-53.
  16. Jeong-Sook Seo 1, Dae-Hee Kim, Won-Jang Kim, Jong-Min Song, Duk-Hyun Kang, Jae-Kwan Song: Peak systolic velocity ofmitral annular longitudinal movement measured by pulsed tissue Doppler imaging as an index of global leftventricular contractility. Am J Physiol Heart Circ Physiol 2010;298:H1608–H1615.
  17. Thorstensen A, Dalen H, Amundsen BH,  Støylen A. Peak systolic velocity indices are more sensitive than end-systolic indices in detecting contraction changes assessed by echocardiography in young healthy humans. Eur J Echocardiogram 2011;12:924–930.
  18. Mondillo S,   Maurizio G, Piercarlo B, Paolo N M. Study Group of Echocardiography of the Italian Society of Cardiology. Left ventricular systolic longitudinal function: Comparison among simple M-mode, pulsed, and M-mode color tissue Doppler of mitral annulus in healthy individuals. J Am Soc Echocardiogr 2006 ;19:1085–1091.
  19. Cioffi G ,   Michele S, Luigi T, Pompilio F, Andrea R, Carlo S,et al. Analysis of circumferential and longitudinal left ventricular systolic function in patients with non-ischemic chronic heart failure and preserved ejection fraction (from the CARRY-IN-HFpEF study). Am J Cardiol2012 ;109:383–389.
  20. Bolognesi R, Dimitri Tsialtas ,Angela Luciana Barilli,Carlo Manca,Roberto Zeppellini,Antonio Javernaro,et al  . Detection of early abnormalities of left ventricular function by hemodynamic, echo-tissue Doppler imaging, and mitral Doppler flow techniques in patients with coronary artery disease and normal ejection fraction. J Am Soc Echocardiogr 2001 ;14:764–772.
  21. Dini FL,  Maurizio Galderisi, Stefano Nistri, Simona Buralli, Piercarlo Ballo, Donato Mele,  et al . Abnormal left ventricular longitudinal function assessed by echocardiographic and tissue Doppler imaging is a powerful predictor of diastolic dysfunction in hypertensive patients: The SPHERE study.2013; 168:3351–3358.
  22. Jiaqi Shen, Qiao Zhou, Yue Liu, Runlan Luo, Bijun ,Tan and Guangsen Li . Evaluation of left atrial function in patients with iron-deficiency anemia by two-dimensional speckle tracking echocardiography .Cardiovascular Ultrasound. Shen et al. Cardiovascular Ultrasound (2016) 14:34 DOI 10.1186/s12947-016-0078-z
  23. Flerlage J, Engorn B, eds. The Harriet Lane Handbook: AManual for Pediatric House Officers. 20th ed. Philadelphia, Pa.: Saunder/Elsevier 2015:305.
  24. Short MW, Domagalski JE. Iron deficiency anemia: evaluation and management. Am Fam Physician.2013 ;87(2):98-104

 

 

Files

Share

How to cite

Statistics