Association of Anemia and Blood Pressure with Novel Markers of Diastolic Function in Pediatric Sickle Cell Disease

Simone Jhaveri, Nadine Choueiter, Deepa Manwani, Saritha Ranabothu, Kerry Morrone, Michael Hafeman, Kimberly Reidy, Frederick Kaskel, Joseph Mahgerefteh

Research output: Contribution to journalArticlepeer-review


Diastolic dysfunction is a known cause of mortality in adults with sickle cell disease (SCD). Left atrial function (LAf) and strain (LAS) are novel echocardiographic parameters to assess early diastolic dysfunction, which have not been assessed in pediatric SCD. Through a retrospective single-center study, we describe echocardiographic parameters of diastology in children with SCD and evaluate their relationship with clinical variables including anemia and blood pressure. Baseline clinical data, 24-hour ambulatory blood pressure monitoring data and echocardiography results were collected. LAf and LAS were measured using volumetric data and speckle-tracking echocardiography, respectively. Sixty-seven children with SCD (13.5±7 y, 47% male, 7% hypertensive) with a mean hemoglobin of 8.8±1.3 g/dL, LAf of 61±8% (n=53) and LAS of 46.3±7.4% (n=28) were included. LAS was significantly associated with hemoglobin (ρ=0.43, P=0.022) but not with maximal left atrial (LA) volume (ρ=-0.05, P=0.79) or any blood pressure parameters. On multivariate analysis, LAS decreased by 3.2% (1.3, 5.1) and LA volume increased by 1.6 mL/m2(3.1, 0.08) for every 1 g/dL decrease in hemoglobin. Thus, severity of baseline anemia in pediatric SCD correlates with diastolic function as measured by LAS, independent of LA dilation.

Original languageEnglish (US)
Pages (from-to)E486-E493
JournalJournal of Pediatric Hematology/Oncology
Issue number4
StatePublished - May 2021


  • diastolic function
  • hypertension
  • left atrial function
  • left atrial strain
  • sickle cell anemia

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology


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