Cardiac Enlargement in Chronic Severe Anemia

Sanghvi, L. M.; Misra, S. N.; Banerjee, Kushal K.

doi:10.1161/01.cir.22.3.412

Cited by 8 publications

(6 citation statements)

References 14 publications

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“…However, other symptoms and signs resulting from hypoxic functioning occurred after physical activity, such as fatigue, exertional dyspnoea progressing to breathlessness at rest, and vertigo. In previously published studies ( 18 , 19 ), cardiac functional damage was determined by X-ray and conventional echocardiography in patients with anemia; it was found that cardiac enlargement, LV hypertrophy, and heart dysfunction are common in patients with chronic severe anemia. It is difficult to diagnose cardiac damage at an early stage.…”

Section: Discussionmentioning

confidence: 99%

Assessment of left ventricular systolic function in patients with iron deficiency anemia by three-dimensional speckle-tracking echocardiography

Zhou

Shen²,

Liu³

et al. 2017

Anatol J Cardiol

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Objective:The present study aimed to evaluate left ventricular (LV) systolic function in patients with iron deficiency anemia (IDA) by 3-dimensional speckle-tracking echocardiography (3DSTE).Methods:Participants were grouped by hemoglobin (Hb) levels in order to study the effect of anemia on cardiac function. Group A included 40 healthy volunteers. Eighty-three patients who were diagnosed with IDA were divided into 2 groups according to the Hb level. Group B (Hb 9 g/dL) included 44 patients, while group C (Hb 6–9 g/dL) included 39 patients. Left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left ventricular mass index (LVMI), and left ventricular ejection fraction (LVEF) were calculated by real-time 3-dimensional echocardiography (RT3D). Left ventricular global longitudinal strain (GLS), global area strain (GAS), global radial strain (GRS), and global circumferential strain (GCS) were obtained by 3DSTE.Results:LVMI, LVEDV and LVESV of group C increased and GCS, GRS, GLS, and GAS of group C decreased compared with those of groups A and B (all p<0.05). GAS and GLS decreased significantly compared with other parameters (both p<0.01).Conclusion:LV remodeling and LV systolic dysfunction occurred in patients when the hemoglobin level was in the range of 6–9 g/dL. 3DSTE can evaluate LV systolic function in patients with IDA, and GAS and GLS are more sensitive than other parameters.

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Section: Discussionmentioning

confidence: 99%

Assessment of left ventricular systolic function in patients with iron deficiency anemia by three-dimensional speckle-tracking echocardiography

Zhou

Shen²,

Liu³

et al. 2017

Anatol J Cardiol

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“…Sanghvi et al reported that 120 of 155 patients reported cardiac enlargement by chest X-ray, and enlargement disappeared rapidly in 92 patients with correction of the anemia in 1960 [9]. More recently than previous study, Naito et al showed that chronic iron-deficiency anemia leads to LV hypertrophy and HF in molecular level among animals [10].…”

Section: Discussionmentioning

confidence: 97%

“…Among them, chronic anemia is a major cause of high cardiac output state which we easily encounter in daily practice [8]. However, there are only few studies exist which evaluating cardiac enlargement [9] or clinical implications [10,11] in patients with chronic anemia. Most recently, Hammoudi et al reported that LA volume is not an index of LV diastolic dysfunction in patients with sickle cell anemia [12], however, sickle cell anemia is very rare in South Korea.…”

Section: Introductionmentioning

confidence: 99%

Factors Associated with Left Atrial Enlargement in Patients with Anemia Caused by Uterine Myoma

Kim¹,

Kang²

2016

J Clin Exp Cardiolog

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Background: Uterine myoma (UM) is common among female gender, and it often causes anemia. Left atrial enlargement (LAE) is commonly detected in patients with anemia as well as caused by uterine myoma. Therefore, this study was aimed to investigate the clinical implications of LAE and its associating factors in patients with anemia caused by UM.Methods: This is a retrospective observational cross sectional study and it considered 139 female patients with UM who had undergone preoperative echocardiography. Patients were sorted into 2 groups according to the presence of LAE (n=60) or not (n=79). LAE was defined as LA volume index (LAVI) was 35 ml/m 2 or more Results: Patients with LAE (LAVI: 41.0 ± 5.3 ml/m 2 ) showed larger left ventricular (LV) dimension and increased LV mass index (LVMI) than patients without LAE (LAVI: 27.9 ± 3.9 ml/m 2 ). Patients with LAE were older, showed slower heart rate (HR) and further decreased level of hemoglobin. Older age, slower HR, level of hemoglobin, larger LV, increased LMI, E/E', right ventricular systolic pressure and decreased S' velocity were shown to be correlated with increased LAVI. Among them, older age (OR: 1.119, 95% CI: 1.014-1.236, p=0.026) and slower HR (OR: 0.926, 95% CI: 0.878-0.977, p=0.005) were independently associated with LAE in patients with anemia caused by UM.Conclusion: LAE was often noticed in patients with anemia caused by UM and older age and slower HR were seemed to be its associating factor.

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“…2 Severe anemia is associated with a high incidence of cardiac enlargement and may result in congestive heart failure. 3,4 Chronic severe anemia is known to increase cardiac output when hemoglobin levels drop to < 7 g/dL for three months or more duration. 5 Cardiac enlargement in patients with chronic severe anemia has been reported in necropsy studies.…”

mentioning

confidence: 99%

“…In addition, cardiac enlargement has been attributed to dilatation or hypertrophy. 3 Chest roentgenogram is routinely used to assess the presence cardiac enlargement. The aim of our study was to determine the relationship between hemoglobin level and cardiothoracic ratio in children with chronic severe anemia.…”

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confidence: 99%

Hemoglobin level and cardiothoracic ratio in children with chronic severe anemia

Wahyuni

Ali

Lubis

et al. 2011

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Background Chronic severe anemia is known to increase cardiac output when the hemoglobin levels are < 7 g/dL for more than three months. Chronic severe anemia is also associated with a high incidence of cardiac enlargement and congestive heart failure.Objective To determine the relationship between hemoglobin level and cardiothoracic ratio in children with chronic severe anemia.Methods We conducted a cross-sectional study in Haji Adam Malik Hospital, Medan, Indonesia from October to December 2009. Subjects had chronic severe anemia and were aged 1 to 15 years. Hematological data was collected at the beginning of the study. The heart was considered enlarged if the cardiothoracic ratio (CTR) was greater than 50% (0.50) by chest roentgenogram. We used simple linear regression to analyze the relationship between hemoglobin and CTR values.Results Thirty subjects enrolled in our study. Their mean age was 115.7 months (SD 56.95). Hemoglobin levels ranged from 2.1 to 6.9 g/dL. The mean hemoglobin level and duration of anemia were 4.71 g/dL (SD 1.48) and 3.9 months (SD 0.70), respectively. Heart enlargement was observed in 23 patients (76.6%). The CTR ranged from 0.52 to 0.69, with a mean of 0.54 (SD 0.06). We found a significant correlation between CTR and hemoglobin levels with Pearson’s correlation coefficient, (r) = - 0.612 and P = 0.001.Conclusion Low hemoglobin levels significantly correlated with high CTR values in children with chronic severe anemia. [Paediatr Indones. 2011;51:262-5].

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Cardiac Enlargement in Chronic Severe Anemia

Cited by 8 publications

References 14 publications

Assessment of left ventricular systolic function in patients with iron deficiency anemia by three-dimensional speckle-tracking echocardiography

Assessment of left ventricular systolic function in patients with iron deficiency anemia by three-dimensional speckle-tracking echocardiography

Factors Associated with Left Atrial Enlargement in Patients with Anemia Caused by Uterine Myoma

Hemoglobin level and cardiothoracic ratio in children with chronic severe anemia

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