Abstract:
BACKGROUND:Patients with sickle cell anemia (SCA) frequently present with episodes of chest pain, alterations in the resting electrocardiogram, and changes in cardiac structure and functions. OBJECTIVE:To evaluate the effect of recurrent episodes of vaso-occlusion on the coronary microcirculation. METHODS:Coronary flow velocity and coronary flow reserve (CFR) of stable patients with SCA (n=10, 5 females, 24.4+/-5.4 years) were measured in the anterior descending coronary artery with transesophageal echocardiogram at baseline and after intravenous adenosine-induced maximum hyperemia, and compared to those of patients with sickle cell trait (TRA, n=10, 5 females, 27.7+/-3.2 years), iron deficiency anemia (IRO, n=8, 8 females, 26.6+/-5.2 years) and control group (NOR, n=10, 5 females, 26.3+/-6.3 years). RESULTS:The SCA group presented increased diastolic coronary flow velocities (p<0.01) at baseline and during maximum hyperemia (67.3+/-14.0 and 198.2+/-37.9 cm/s, respectively) when compared with the other three groups - TRA (34.4+/-11.9 and 114.7+/-36.4 cm/s), IRO (42.4+/-10.4 and 141.0+/-18.7 cm/s) and NOR (38.1+/-10.0 and 126.8+/-24.6 cm/s). However, CFR was normal in the SCA group (3.0+/-0.7) and comparable (p=0.70) to the other groups - TRA (3.4+/-0.8), IRO (3.5+/-1.2), and NOR (3.4+/-0.8). CONCLUSION:Despite the higher coronary flow velocities already observed at baseline and also during maximum hyperemia, CFR is normal in SCA, which suggests preserved coronary microcirculation. The episodes of vaso-occlusion are not responsible for the cardiologic findings in this disease.
journal_name
Arq Bras Cardioljournal_title
Arquivos brasileiros de cardiologiaauthors
de Souza JL Jr,Rodrigues AC,Buck PC,Guallandro SF,Mady Cdoi
10.1590/s0066-782x2007000500009subject
Has Abstractpub_date
2007-05-01 00:00:00pages
552-8issue
5eissn
0066-782Xissn
1678-4170pii
S0066-782X2007000500009journal_volume
88pub_type
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