Longitudinal exercise hemodynamics in children with sickle cell anemia
B. S. Alpert, E. V. Dover, W. B. Strong and W. Covitz
To define further the natural history and causative factors in
exercise-related cardiac dysfunction in children and adolescents with
sickle cell anemia (SS), we studied the results of 74 patients' initial and
follow-up exercise tests. The follow-up study was done one to three years
after the first study in 36 children and four to seven years after initial
testing in 38 children. Split-plot analysis of covariance did not show any
temporal deterioration in exercise hemodynamic variables. Correlation
analysis defined hemoglobin and hematocrit levels as critical determinants
of cardiac functional reserve capacity in these patients. Several exercise
ECG patterns, formerly considered abnormal in children with SS, are now
considered to be variants of normal. Studies are presently in progress that
should further define the nature and severity of the cardiac impairment
during exercise in children with SS.
