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Teresa Cristina de Abreu Ferrarihttp://lattes.cnpq.br/8298538465228015Maria do Carmo Pereira NunesTeresa Cristina de Abreu FerrariMaria do Carmo Pereira NunesCarlos Faria Santos AmaralBenigna Maria de Oliveirahttp://lattes.cnpq.br/9721039778886539Maria Carmen Melo Vasconcelos2021-10-20T18:11:50Z2021-10-20T18:11:50Z2013-11-29http://hdl.handle.net/1843/384490000-0002-8967-4647As complicações cardiovasculares na doença falciforme (DF) são frequentes, e têm sido atualmente mais frequentemente detectadas, em decorrência da maior longevidade dos pacientes. Como metodologia altamente informativa e confiável, a ecocardiografia possibilita análise acurada da morfologia e função cardíaca. Estudos prévios avaliaram especialmente a hipertensão pulmonar e suas consequências sobre as câmaras cardíacas direitas, permanecendo pobremente compreendidos os fatores associados às alterações morfológicas do ventrículo esquerdo (VE). O objetivo deste estudo foi investigar parâmetros clínicos, laboratoriais e ecocardiográficos associados ao remodelamento do VE, além de avaliar o valor do strain bidimensional em detectar disfunção atrial e ventricular em pacientes com DF. Método: foram investigados 90 pacientes consecutivamente recrutados em serviço de referência, com hemoglobinopatia SS ou S-beta-talassemia zero, com idade média de 287 anos (limites, 18-40 anos), sem doenças associadas, e 20 controles sadios com idade e sexo semelhantes. Foram realizados exames laboratoriais habituais, eletrocardiograma (ECG) convencional e ecocardiografia, incluindo-se doppler tecidual e strain de todos os pacientes. Resultados: nos pacientes com DF foi observado aumento nas dimensões das câmaras cardíacas direitas e esquerdas, na massa do VE e na velocidade de regurgitação tricúspide, quando comparados com os controles. Apesar da dilatação das câmaras, a função sistólica de ambos os ventrículo estava preservada. As velocidades de fluxo mitral estavam aumentadas nos pacientes, em relação aos controles, enquanto que velocidades do anel mitral septal e lateral estavam normais, sugerindo relaxamento normal do VE. Os pacientes que estavam em hipertransfusão ou em uso de hidroxiureia apresentaram maiores concentrações de hemoglobina, mas achados ecocardiográficos similares, em comparação àqueles sem tratamento. Pressão arterial sistólica, concentração de ferritina, velocidade de regurgitação tricúspide (TRV), tempo de desaceleração da onda E mitral e razão E/e’ foram independentemente associados ao aumento da massa do VE. O strain dos dois ventrículos e átrios não diferiu daquele dos controles. Conclusão: o remodelamento do VE nos pacientes com DF parece estar associado a uma combinação de fatores, incluindo-se pressão arterial sistêmica, concentração de ferritina, VRT e parâmetros ecocardiográficos de função diastólica. A análise do strain de ambos os ventrículos e átrios não evidenciou disfunção sistólica incipiente nesse grupo de pacientes com DF.Cardiovascular complications in sickle cell disease (SCD) are common, and have been frequently found nowadays, due to increased longevity of the patients. As a highly informative and reliable method, echocardiography allows an accurate analysis of cardiac morphology and function. Previous studies have focused especially on pulmonar hypertension and its consequence on the rigth-side heart chambers, whereas factors associated with morphological changes in left ventricle (LV) remain poorly understood. The present study was designed to identify clinical, laboratorial and echocardiographic parametes associated with LV remodeling in SCD patients. Methods: ninety consecutive SCD patients, mean age of 28 ± 7 years (range, 18-40 years) without any associated diseases and 20 age- and gender-balanced healthy subjects were enrolled into the study. Standard laboratory tests, 12-lead ECG and a comprehensive echocardiogram with tissue Doppler imaging were performed in all patients. Results: patients with SCD had larger left and rigth heart chambers dimensions, LV mass and tricuspid regurgitation (TR) velocity compared to controls. Despiste chambers enlargement, systolic function of both ventricles was preserved. The mitral inflow velocites were higher in the pacientes than in controls, whereas septal and lateral anular motion velocities were normal, suggesting normal LV relaxation. SCD pacientes who were on hydroxyurea therapy and/or hypertransfusion had higer hemoglobina concentrations, but similar echocardiographic findings in comparison to the individuals without treatment. Systolic blood pressure, ferritin concentration, TR velocity, deceleration time of early mitral inflow velocity, and E/e’ratio were independently associated with increased LV mass. Speckle tracking of both ventricles and atria were not diferent from those of the controls. Conclusions: LV remodeling in SCD pacientes seems to be influenced by a combination of factors including blood pressure, ferritin concentration, TR velocity, and parameters of LV diastolic function. Speckle tracking of both ventricles and atria could not detect any incipiente systolic dysfunction in this group of SCD patients.FAPEMIG - Fundação de Amparo à Pesquisa do Estado de Minas GeraisporUniversidade Federal de Minas GeraisPrograma de Pós-Graduação em Ciências Aplicadas à Saúde do AdultoUFMGBrasilMEDICINA - FACULDADE DE MEDICINAPrograma Institucional de Internacionalização – CAPES - PrInthttp://creativecommons.org/licenses/by-nd/3.0/pt/info:eu-repo/semantics/openAccessEcocardiografiaAnemia FalciformeDoenças CardiovascularesLongevidadeEcocardiografiaAnemia FalciformeDoenças CardiovascularesLongevidadeDissertações AcadêmicasAvaliação ecocardiográfica de pacientes com doença falciformeEchocardiographic evaluation of patients with sickle cell diseaseinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisreponame:Repositório Institucional da UFMGinstname:Universidade Federal de Minas Gerais (UFMG)instacron:UFMGORIGINALFinal.pdfFinal.pdfapplication/pdf1892953https://repositorio.ufmg.br/bitstream/1843/38449/4/Final.pdf1a69fbd62229a08cb0fadb1e4bbbb108MD54LICENSElicense.txtlicense.txttext/plain; charset=utf-82118https://repositorio.ufmg.br/bitstream/1843/38449/5/license.txtcda590c95a0b51b4d15f60c9642ca272MD55CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-8805https://repositorio.ufmg.br/bitstream/1843/38449/2/license_rdf00e5e6a57d5512d202d12cb48704dfd6MD521843/384492021-10-20 15:11:51.243oai:repositorio.ufmg.br:1843/38449TElDRU7Dh0EgREUgRElTVFJJQlVJw4fDg08gTsODTy1FWENMVVNJVkEgRE8gUkVQT1NJVMOTUklPIElOU1RJVFVDSU9OQUwgREEgVUZNRwoKQ29tIGEgYXByZXNlbnRhw6fDo28gZGVzdGEgbGljZW7Dp2EsIHZvY8OqIChvIGF1dG9yIChlcykgb3UgbyB0aXR1bGFyIGRvcyBkaXJlaXRvcyBkZSBhdXRvcikgY29uY2VkZSBhbyBSZXBvc2l0w7NyaW8gSW5zdGl0dWNpb25hbCBkYSBVRk1HIChSSS1VRk1HKSBvIGRpcmVpdG8gbsOjbyBleGNsdXNpdm8gZSBpcnJldm9nw6F2ZWwgZGUgcmVwcm9kdXppciBlL291IGRpc3RyaWJ1aXIgYSBzdWEgcHVibGljYcOnw6NvIChpbmNsdWluZG8gbyByZXN1bW8pIHBvciB0b2RvIG8gbXVuZG8gbm8gZm9ybWF0byBpbXByZXNzbyBlIGVsZXRyw7RuaWNvIGUgZW0gcXVhbHF1ZXIgbWVpbywgaW5jbHVpbmRvIG9zIGZvcm1hdG9zIMOhdWRpbyBvdSB2w61kZW8uCgpWb2PDqiBkZWNsYXJhIHF1ZSBjb25oZWNlIGEgcG9sw610aWNhIGRlIGNvcHlyaWdodCBkYSBlZGl0b3JhIGRvIHNldSBkb2N1bWVudG8gZSBxdWUgY29uaGVjZSBlIGFjZWl0YSBhcyBEaXJldHJpemVzIGRvIFJJLVVGTUcuCgpWb2PDqiBjb25jb3JkYSBxdWUgbyBSZXBvc2l0w7NyaW8gSW5zdGl0dWNpb25hbCBkYSBVRk1HIHBvZGUsIHNlbSBhbHRlcmFyIG8gY29udGXDumRvLCB0cmFuc3BvciBhIHN1YSBwdWJsaWNhw6fDo28gcGFyYSBxdWFscXVlciBtZWlvIG91IGZvcm1hdG8gcGFyYSBmaW5zIGRlIHByZXNlcnZhw6fDo28uCgpWb2PDqiB0YW1iw6ltIGNvbmNvcmRhIHF1ZSBvIFJlcG9zaXTDs3JpbyBJbnN0aXR1Y2lvbmFsIGRhIFVGTUcgcG9kZSBtYW50ZXIgbWFpcyBkZSB1bWEgY8OzcGlhIGRlIHN1YSBwdWJsaWNhw6fDo28gcGFyYSBmaW5zIGRlIHNlZ3VyYW7Dp2EsIGJhY2stdXAgZSBwcmVzZXJ2YcOnw6NvLgoKVm9jw6ogZGVjbGFyYSBxdWUgYSBzdWEgcHVibGljYcOnw6NvIMOpIG9yaWdpbmFsIGUgcXVlIHZvY8OqIHRlbSBvIHBvZGVyIGRlIGNvbmNlZGVyIG9zIGRpcmVpdG9zIGNvbnRpZG9zIG5lc3RhIGxpY2Vuw6dhLiBWb2PDqiB0YW1iw6ltIGRlY2xhcmEgcXVlIG8gZGVww7NzaXRvIGRlIHN1YSBwdWJsaWNhw6fDo28gbsOjbywgcXVlIHNlamEgZGUgc2V1IGNvbmhlY2ltZW50bywgaW5mcmluZ2UgZGlyZWl0b3MgYXV0b3JhaXMgZGUgbmluZ3XDqW0uCgpDYXNvIGEgc3VhIHB1YmxpY2HDp8OjbyBjb250ZW5oYSBtYXRlcmlhbCBxdWUgdm9jw6ogbsOjbyBwb3NzdWkgYSB0aXR1bGFyaWRhZGUgZG9zIGRpcmVpdG9zIGF1dG9yYWlzLCB2b2PDqiBkZWNsYXJhIHF1ZSBvYnRldmUgYSBwZXJtaXNzw6NvIGlycmVzdHJpdGEgZG8gZGV0ZW50b3IgZG9zIGRpcmVpdG9zIGF1dG9yYWlzIHBhcmEgY29uY2VkZXIgYW8gUmVwb3NpdMOzcmlvIEluc3RpdHVjaW9uYWwgZGEgVUZNRyBvcyBkaXJlaXRvcyBhcHJlc2VudGFkb3MgbmVzdGEgbGljZW7Dp2EsIGUgcXVlIGVzc2UgbWF0ZXJpYWwgZGUgcHJvcHJpZWRhZGUgZGUgdGVyY2Vpcm9zIGVzdMOhIGNsYXJhbWVudGUgaWRlbnRpZmljYWRvIGUgcmVjb25oZWNpZG8gbm8gdGV4dG8gb3Ugbm8gY29udGXDumRvIGRhIHB1YmxpY2HDp8OjbyBvcmEgZGVwb3NpdGFkYS4KCkNBU08gQSBQVUJMSUNBw4fDg08gT1JBIERFUE9TSVRBREEgVEVOSEEgU0lETyBSRVNVTFRBRE8gREUgVU0gUEFUUk9Dw41OSU8gT1UgQVBPSU8gREUgVU1BIEFHw4pOQ0lBIERFIEZPTUVOVE8gT1UgT1VUUk8gT1JHQU5JU01PLCBWT0PDiiBERUNMQVJBIFFVRSBSRVNQRUlUT1UgVE9ET1MgRSBRVUFJU1FVRVIgRElSRUlUT1MgREUgUkVWSVPDg08gQ09NTyBUQU1Cw4lNIEFTIERFTUFJUyBPQlJJR0HDh8OVRVMgRVhJR0lEQVMgUE9SIENPTlRSQVRPIE9VIEFDT1JETy4KCk8gUmVwb3NpdMOzcmlvIEluc3RpdHVjaW9uYWwgZGEgVUZNRyBzZSBjb21wcm9tZXRlIGEgaWRlbnRpZmljYXIgY2xhcmFtZW50ZSBvIHNldSBub21lKHMpIG91IG8ocykgbm9tZXMocykgZG8ocykgZGV0ZW50b3IoZXMpIGRvcyBkaXJlaXRvcyBhdXRvcmFpcyBkYSBwdWJsaWNhw6fDo28sIGUgbsOjbyBmYXLDoSBxdWFscXVlciBhbHRlcmHDp8OjbywgYWzDqW0gZGFxdWVsYXMgY29uY2VkaWRhcyBwb3IgZXN0YSBsaWNlbsOnYS4KRepositório InstitucionalPUBhttps://repositorio.ufmg.br/oaiopendoar:2021-10-20T18:11:51Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG)false
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