IJCRR - Vol 06 Issue 11, June, 2014
STUDY OF LEFT VENTRICULAR MASS IN CHRONIC SEVERE ANEMIA
Author: Farquana Qushnood, Ruqia Asna, Salim A. Dhundasi, K. K. Das
Background and Objectives: In chronic anemia the heart has to entertain a hyperdynamic circulation in order to compensate for reduced oxygen carrying capacity of blood. Chronic alterations of cardiac workload results in changes of LV geometry. The diagnosis of left ventricular hypertrophy (LVH) based on LV mass has been incorporated in the clinical practice as an important marker of CVD. Hence, present study was undertaken with the objective of estimating the LV mass in pts with chronic severe anemia and comparing with controls. Methodology: Present study was conducted in Al-Ameen Medical College and District Hospital, Bijapur. 31 anemic patients (aged 18-40 yrs) with Hb ? 7 gm% and equal no. of age and gender matched normal subjects were selected. All anemic patients and controls were subjected for hemoglobin estimation and M mode 2D Echocardiography. Echocardiographic parameters IVSTd, LVPWd, LVIDd were studied, LVM and LVMI were derived. Statistics-by Student’s unpaired‘t’ test, correlation analysis. Results: Our study demonstrated increased LVM and LVMI in anemic patients compared to controls. Both correlated negatively with Hb levels. Interpretation and Conclusion: Left ventricular mass is an independent risk factor for prediction of cardiovascular events.Echocardiography is a simple, noninvasive imaging method in the evaluation of cardiac morphology and dynamics, hence can be used to evaluate LVM in chronic anemia. The findings of increased LVM and LVMI in anemic patients of our study are indicative of LV hypertrophy. Hypertrophy of cardiac myocytes occurs to meet the demand of increased rate of use of mechanical energy in response to sustained Hemodynamic overloading of the heart.
Keywords: Left ventricular Mass, Chronic anemia, LVH, Echocardiography.
Farquana Qushnood, Ruqia Asna, Salim A. Dhundasi, K. K. Das. STUDY OF LEFT VENTRICULAR MASS IN CHRONIC SEVERE ANEMIA International Journal of Current Research and Review. Vol 06 Issue 11, June, 71-78
1. Heribert Schunkert, Hans W Hense. A heart price to pay for anemia.Nephrol Dial Transpalant 2001; 16: 445-448.
2. Manish G. Amin, HocineTighiouart, Daniel E. Weiner, Paul C. Stark, John L. Griffith, Bonnie MacLeod et.al. Hematocrit and Left Ventricular Mass:The Framingham Heart Study. J. Am. Coll. Cardiol. 2004; 43: 1276- 1282.
3. Stritzke J, Mayer B, Lieb W, Luchner A, Döring A, Hense HW, Schunkert H. Haematocrit levels and left ventricular geometry: Results of the MONICA Augsburg Echocardiographic Substudy. J Hpertens 2007 Jun; 25 (6):1301-9.
4. MuriloFoppa, Bruce B Duncan and Luis EP Rohde.Echocardiography based left ventricular mass estimation. How should we define hypertrophy.Cardiovascular Ultrasound 2005; 3(17): 1-13.
5. National Family Health Survey NFHS 2 India 1998- International Institute for Population Sciences, Mumbai, MEASURE DHS + ORC and MACRO.
6. Takahashi M, Kurokawa S, Tsuyusaki T, Kikawada R. Studies of hyperkinetic circulatory state in chronic anemia. J Cardiol 1990; 20 (2):331-9.
7. Bahl VK, Malhotra OP, Kumar D, Agarwal R, Goswami KC, Bajaj R, et al. Non-invasive assessment of systolic and diastolic left ventricular function in patients with chronic severe anemia: A combined M-mode, twodimensional, and Doppler echocardiographic study. Am Heart J 1992; 124: 1516-23.
8. Metivier F, Marchais SJ, Guerin AP, Pannier B, London GM. Pathophysiology of anaemia: Focus on the heart and blood vessels. Nephrol Dial Transplant 2000;15Suppl 3: 14-8.
9. Alvares JF, Oak JL, Pathare AV. Evaluation of cardiac function in iron deficiency anemia before and after total dose iron therapy. J Assoc Physicians India 2000; 48: 204-6.
10. Denis M. Medeirosand John L. Beard.Dietary Iron Deficiency Results in Cardiac Eccentric Hypertrophy in Rats. ProcSocExpBiol Med. 1998 Sep; 218(4): 370-5.
11. Levin A, Singer J, Thompson CR, Ross H, Lewis M. Prevalent left ventricular hypertrophy in the predialysis population: Identifying opportunities for intervention. Am J Kidney Dis. 1996 Mar; 27(3): 347-54.
12. Varat MA, Adolph RJ, Fowler NO. Cardiovascular effects of anemia.Am Heart J 1972; 83: 415-26.
13. Taksande A, Vilhekar K, Jain M, Ganvir B. Left ventricular systolic and diastolic functions in patients with sickle cell anemia. Indian Heart J 2005 Nov-Dec; 57(6): 694-7.
14. ValentinFuster, R. Wayne Alexander, Robert A.O Rourke, Robert Roberts, Spencer B. King III, Ira S. Nash et al. Hurst’s THE HEART. 11thed. New York: McGraw Hill companies; 2004.