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GENDER DIFFERENCES IN THE DEVELOPMENT OF CMR ABNORMALITIES AND CARDIAC COMPLICATIONS: A MULTICENTRIC PROSPECTIVE STUDY IN A COHORT OF SICKLE CELL DISEASE PATIENTS
Author(s):
Antonella Meloni
,
Antonella Meloni
Affiliations:
Fondazione G. Monasterio CNR-Regione Toscana,Pisa,Italy
Laura Pistoia
,
Laura Pistoia
Affiliations:
Fondazione G. Monasterio CNR-Regione Toscana,Pisa,Italy
Calogera Gerardi
,
Calogera Gerardi
Affiliations:
Presidio Ospedaliero 'Giovanni Paolo II' - Distretto AG2 di Sciacca,Sciacca,Italy
Elena Facchini
,
Elena Facchini
Affiliations:
Azienda Ospedaliero-Universitaria di Bologna - Policlinico “S. Orsola-Malpighi”,Bologna,Italy
Massimo Allò
,
Massimo Allò
Affiliations:
Presidio Ospedaliero ASL 5,Crotone,Italy
Maria Paola Smacchia
,
Maria Paola Smacchia
Affiliations:
Policlinico Umberto 1,Roma,Italy
Saveria Campisi
,
Saveria Campisi
Affiliations:
Presidio Ospedaliero “Umberto I”,Siracusa,Italy
Silvia Maffei
,
Silvia Maffei
Affiliations:
Fondazione G. Monasterio CNR-Regione Toscana,Pisa,Italy
Valentina Vinci
,
Valentina Vinci
Affiliations:
Azienda Ospedaliera 'Garibaldi' Presidio Ospedaliero Nesima,Catania,Italy
Gennaro Restaino
,
Gennaro Restaino
Affiliations:
Fondazione di Ricerca e Cura 'Giovanni Paolo II',Campobasso,Italy
Vincenzo Positano
,
Vincenzo Positano
Affiliations:
Fondazione G. Monasterio CNR-Regione Toscana,Pisa,Italy
Alessia Pepe
Alessia Pepe
Affiliations:
Fondazione G. Monasterio CNR-Regione Toscana,Pisa,Italy
(Abstract release date: 05/18/17) EHA Library. Meloni A. 05/18/17; 182866; PB2153
Dr. Antonella Meloni
Dr. Antonella Meloni
Contributions
PDF Abstract
Abstract

Abstract: PB2153

Type: Publication Only

Background
No data are available in literature about the relationship between gender and the development of CMR abnormalities and/or cardiac complications in sickle cell disease (SCD).

Aims
This prospective and multicentre study aimed to assess if there was an association between gender and risk of cardiac iron overload, heart dysfunction and dilation, left ventricular (LV) hypertrophy, and myocardial fibrosis, assessed by Cardiovascular Magnetic Resonance (CMR), and of cardio-vascular complications in sickle cell disease (SCD) patients.

Methods
We considered 115 SCD patients (58 females, 34.79±13.26 years), consecutively enrolled in the Myocardial Iron Overload in Thalassemia (MIOT) Network. Myocardial iron overload was assessed by the multislice multiecho T2* technique. Biventricular function parameters and atrial areas were quantified by cine images. Late gadolinium enhancement (LGE) images were acquired to detect myocardial fibrosis.

Results

Table 1 shows the comparison between sexes in the development of cardiac outcomes.
Males and fameles showed a similar risk of accumulating cardiac iron, but both patients with cardiac iron were females.
Compared to females, males showed a significant lower risk of developing LV hypertrophy, although having a similar risk for biventricular dilation and dysfunction and for myocardial fibrosis. No patients with less than 31 years developed LV hypertrophy and age at the CMR was significantly higher in patients with LV hypertrophy versus patients without it (41.24±75.98 years versus 34.47±13.37 years; P=0.003).
We recorded 12 (10.4%) cardiac events: 4 ischemic strokes, 5 arrhythmias (4 supraventricular and 1 ventricular), two pulmonary hypertensions and one pulmonary embolism. No prospective association was detected between gender and cardiac complications.

Conclusion

In SCD male and female seem to show a comparable risk in developing cardiac complication, although compared to females, males showed a significant lower risk of developing LV hypertrophy. There are no specific guidelines for SCD patients and, as a consequence, the cardiovascular follow-up is conformed to that one of thalassemia patients (complete cardiac evaluation performed annually for both genders). Our data not support a different follow up time based on the gender.

Session topic: 25. Sickle cell disease

Keyword(s): Magnetic resonance imaging, Gender

Abstract: PB2153

Type: Publication Only

Background
No data are available in literature about the relationship between gender and the development of CMR abnormalities and/or cardiac complications in sickle cell disease (SCD).

Aims
This prospective and multicentre study aimed to assess if there was an association between gender and risk of cardiac iron overload, heart dysfunction and dilation, left ventricular (LV) hypertrophy, and myocardial fibrosis, assessed by Cardiovascular Magnetic Resonance (CMR), and of cardio-vascular complications in sickle cell disease (SCD) patients.

Methods
We considered 115 SCD patients (58 females, 34.79±13.26 years), consecutively enrolled in the Myocardial Iron Overload in Thalassemia (MIOT) Network. Myocardial iron overload was assessed by the multislice multiecho T2* technique. Biventricular function parameters and atrial areas were quantified by cine images. Late gadolinium enhancement (LGE) images were acquired to detect myocardial fibrosis.

Results

Table 1 shows the comparison between sexes in the development of cardiac outcomes.
Males and fameles showed a similar risk of accumulating cardiac iron, but both patients with cardiac iron were females.
Compared to females, males showed a significant lower risk of developing LV hypertrophy, although having a similar risk for biventricular dilation and dysfunction and for myocardial fibrosis. No patients with less than 31 years developed LV hypertrophy and age at the CMR was significantly higher in patients with LV hypertrophy versus patients without it (41.24±75.98 years versus 34.47±13.37 years; P=0.003).
We recorded 12 (10.4%) cardiac events: 4 ischemic strokes, 5 arrhythmias (4 supraventricular and 1 ventricular), two pulmonary hypertensions and one pulmonary embolism. No prospective association was detected between gender and cardiac complications.

Conclusion

In SCD male and female seem to show a comparable risk in developing cardiac complication, although compared to females, males showed a significant lower risk of developing LV hypertrophy. There are no specific guidelines for SCD patients and, as a consequence, the cardiovascular follow-up is conformed to that one of thalassemia patients (complete cardiac evaluation performed annually for both genders). Our data not support a different follow up time based on the gender.

Session topic: 25. Sickle cell disease

Keyword(s): Magnetic resonance imaging, Gender

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