Altered ventricular longitudinal strain in children with sickle cell disease: Role of TGF‐β and IL‐18

Background Cardiovascular involvement in sickle cell disease (SCD) has a great impact on patients’ morbidity and mortality. Recently, interleukin‐18 (IL‐18) and transforming growth factor beta (TGF‐β) were suggested as potential biomarkers for sickle cell cardiomyopathy. Global longitudinal strain (...

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Published in:Pediatric blood & cancer 2024-01, Vol.71 (1), p.e30762-n/a
Main Authors: Wagdy, Reham, Assem, Hala, Abd‐Elmohsen, Ali M., Fata, Aya, Gendy, Wessam El, Gaber, Marwa
Format: Article
Language:English
Subjects:
Cardiomyopathy
Children
deformed myocardium
Echocardiography
Ferritin
Hematology
Hemoglobin
Morbidity
Myocardium
Oncology
Pediatrics
sickle cell cardiomyopathy
Sickle cell disease
speckle tracking echocardiography
strain
TGF‐β and IL‐18
tissue Doppler imaging
Transforming growth factor-b
Ventricle
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Assem, Hala
Abd‐Elmohsen, Ali M.
Fata, Aya
Gendy, Wessam El
Gaber, Marwa
description Background Cardiovascular involvement in sickle cell disease (SCD) has a great impact on patients’ morbidity and mortality. Recently, interleukin‐18 (IL‐18) and transforming growth factor beta (TGF‐β) were suggested as potential biomarkers for sickle cell cardiomyopathy. Global longitudinal strain (GLS) is a reliable early parameter for estimation of deformed myocardium. This study evaluated the role of TGF‐β and IL‐18 as risk indicators of altered strain in patients with SCD. Methods Forty children with SCD (age >5 years) and 40 healthy children as controls, matched in age and sex, were enrolled in the study. All participants were subjected to clinical examination, complete blood count, serum ferritin, TGF‐β, IL‐18, and assessment of cardiac function by echocardiography. Results TGF‐β, IL‐18, and lactic acid dehydrogenase (LDH) were significantly higher among cases (mean age: 10.6 ± 3.5 years) when compared to controls (p 
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Recently, interleukin‐18 (IL‐18) and transforming growth factor beta (TGF‐β) were suggested as potential biomarkers for sickle cell cardiomyopathy. Global longitudinal strain (GLS) is a reliable early parameter for estimation of deformed myocardium. This study evaluated the role of TGF‐β and IL‐18 as risk indicators of altered strain in patients with SCD. Methods Forty children with SCD (age &gt;5 years) and 40 healthy children as controls, matched in age and sex, were enrolled in the study. All participants were subjected to clinical examination, complete blood count, serum ferritin, TGF‐β, IL‐18, and assessment of cardiac function by echocardiography. Results TGF‐β, IL‐18, and lactic acid dehydrogenase (LDH) were significantly higher among cases (mean age: 10.6 ± 3.5 years) when compared to controls (p &lt; .001), at cutoff values 41.7 ng/mL, 128.9 pg/mL, and 340 unit, respectively. The LS of free wall of RV (FW‐RV) was significantly lower among cases when compared to controls (−23.55% ± 5.55% vs. −28.73% ± 2.43%, p &lt; .001). Free wall longitudinal strain of the right ventricle (FWLS‐RV) was significantly correlated to IL‐18 and LDH (p &lt; .001), while GLS‐RV was significantly correlated to TGF‐β. The GLS‐LV was correlated to frequency of vaso‐occlusive crises (VOCs) per year (p &lt; .001). Diastolic function, E/A of LV, and RV were negatively correlated to the hemoglobin and serum ferritin levels. Conclusions The TGF‐β, IL‐18, and LDH along with frequent VOCs are correlated to altered LS, especially the right ventricle, and could serve as risk indicators for subclinical cardiomyopathy in children with SCD.</description><identifier>ISSN: 1545-5009</identifier><identifier>EISSN: 1545-5017</identifier><identifier>DOI: 10.1002/pbc.30762</identifier><language>eng</language><publisher>Glenview: Wiley Subscription Services, Inc</publisher><subject>Cardiomyopathy ; Children ; deformed myocardium ; Echocardiography ; Ferritin ; Hematology ; Hemoglobin ; Morbidity ; Myocardium ; Oncology ; Pediatrics ; sickle cell cardiomyopathy ; Sickle cell disease ; speckle tracking echocardiography ; strain ; TGF‐β and IL‐18 ; tissue Doppler imaging ; Transforming growth factor-b ; Ventricle</subject><ispartof>Pediatric blood &amp; cancer, 2024-01, Vol.71 (1), p.e30762-n/a</ispartof><rights>2023 Wiley Periodicals LLC.</rights><rights>2024 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c2902-1cfd9b21814a07b1a803308e3546447dc94bcf16a8edbedae5ea1add37cd10113</cites><orcidid>0000-0001-6822-5597 ; 0000-0003-0738-9306</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids></links><search><creatorcontrib>Wagdy, Reham</creatorcontrib><creatorcontrib>Assem, Hala</creatorcontrib><creatorcontrib>Abd‐Elmohsen, Ali M.</creatorcontrib><creatorcontrib>Fata, Aya</creatorcontrib><creatorcontrib>Gendy, Wessam El</creatorcontrib><creatorcontrib>Gaber, Marwa</creatorcontrib><title>Altered ventricular longitudinal strain in children with sickle cell disease: Role of TGF‐β and IL‐18</title><title>Pediatric blood &amp; cancer</title><description>Background Cardiovascular involvement in sickle cell disease (SCD) has a great impact on patients’ morbidity and mortality. Recently, interleukin‐18 (IL‐18) and transforming growth factor beta (TGF‐β) were suggested as potential biomarkers for sickle cell cardiomyopathy. Global longitudinal strain (GLS) is a reliable early parameter for estimation of deformed myocardium. This study evaluated the role of TGF‐β and IL‐18 as risk indicators of altered strain in patients with SCD. Methods Forty children with SCD (age &gt;5 years) and 40 healthy children as controls, matched in age and sex, were enrolled in the study. All participants were subjected to clinical examination, complete blood count, serum ferritin, TGF‐β, IL‐18, and assessment of cardiac function by echocardiography. Results TGF‐β, IL‐18, and lactic acid dehydrogenase (LDH) were significantly higher among cases (mean age: 10.6 ± 3.5 years) when compared to controls (p &lt; .001), at cutoff values 41.7 ng/mL, 128.9 pg/mL, and 340 unit, respectively. The LS of free wall of RV (FW‐RV) was significantly lower among cases when compared to controls (−23.55% ± 5.55% vs. −28.73% ± 2.43%, p &lt; .001). Free wall longitudinal strain of the right ventricle (FWLS‐RV) was significantly correlated to IL‐18 and LDH (p &lt; .001), while GLS‐RV was significantly correlated to TGF‐β. The GLS‐LV was correlated to frequency of vaso‐occlusive crises (VOCs) per year (p &lt; .001). Diastolic function, E/A of LV, and RV were negatively correlated to the hemoglobin and serum ferritin levels. Conclusions The TGF‐β, IL‐18, and LDH along with frequent VOCs are correlated to altered LS, especially the right ventricle, and could serve as risk indicators for subclinical cardiomyopathy in children with SCD.</description><subject>Cardiomyopathy</subject><subject>Children</subject><subject>deformed myocardium</subject><subject>Echocardiography</subject><subject>Ferritin</subject><subject>Hematology</subject><subject>Hemoglobin</subject><subject>Morbidity</subject><subject>Myocardium</subject><subject>Oncology</subject><subject>Pediatrics</subject><subject>sickle cell cardiomyopathy</subject><subject>Sickle cell disease</subject><subject>speckle tracking echocardiography</subject><subject>strain</subject><subject>TGF‐β and IL‐18</subject><subject>tissue Doppler imaging</subject><subject>Transforming growth factor-b</subject><subject>Ventricle</subject><issn>1545-5009</issn><issn>1545-5017</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp10M1KAzEQB_BFFKzVg28Q8KKHbTOb_fRWi62FgiL1vGSTWZua7tZk19Kbj-Cz-CA-hE9iasWDIAQyhN-Emb_nnQLtAaVBf1WIHqNJHOx5HYjCyI8oJPu_Nc0OvSNrF47GNEo73mKgGzQoyQtWjVGi1dwQXVePqmmlqrgmtjFcVcQdMVdaGqzIWjVzYpV40kgEak2kssgtXpL72j3VJZmNR5-vbx_vhFeSTKauhvTYOyi5tnjyc3e9h9H1bHjjT2_Hk-Fg6osgo4EPopRZEUAKIadJATyljNEUWRTGYZhIkYWFKCHmKcoCJccIOXApWSIkUADW9c53_65M_dyibfKlstsxeYV1a_MgTeOMZRGjjp79oYu6NW7rrcqCGKIYmFMXOyVMba3BMl8ZteRmkwPNt6nnLvX8O3Vn-zu7Vho3_8P87mq46_gCBWqFVQ</recordid><startdate>202401</startdate><enddate>202401</enddate><creator>Wagdy, Reham</creator><creator>Assem, Hala</creator><creator>Abd‐Elmohsen, Ali M.</creator><creator>Fata, Aya</creator><creator>Gendy, Wessam El</creator><creator>Gaber, Marwa</creator><general>Wiley Subscription Services, Inc</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7TO</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-6822-5597</orcidid><orcidid>https://orcid.org/0000-0003-0738-9306</orcidid></search><sort><creationdate>202401</creationdate><title>Altered ventricular longitudinal strain in children with sickle cell disease: Role of TGF‐β and IL‐18</title><author>Wagdy, Reham ; 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Recently, interleukin‐18 (IL‐18) and transforming growth factor beta (TGF‐β) were suggested as potential biomarkers for sickle cell cardiomyopathy. Global longitudinal strain (GLS) is a reliable early parameter for estimation of deformed myocardium. This study evaluated the role of TGF‐β and IL‐18 as risk indicators of altered strain in patients with SCD. Methods Forty children with SCD (age &gt;5 years) and 40 healthy children as controls, matched in age and sex, were enrolled in the study. All participants were subjected to clinical examination, complete blood count, serum ferritin, TGF‐β, IL‐18, and assessment of cardiac function by echocardiography. Results TGF‐β, IL‐18, and lactic acid dehydrogenase (LDH) were significantly higher among cases (mean age: 10.6 ± 3.5 years) when compared to controls (p &lt; .001), at cutoff values 41.7 ng/mL, 128.9 pg/mL, and 340 unit, respectively. The LS of free wall of RV (FW‐RV) was significantly lower among cases when compared to controls (−23.55% ± 5.55% vs. −28.73% ± 2.43%, p &lt; .001). Free wall longitudinal strain of the right ventricle (FWLS‐RV) was significantly correlated to IL‐18 and LDH (p &lt; .001), while GLS‐RV was significantly correlated to TGF‐β. The GLS‐LV was correlated to frequency of vaso‐occlusive crises (VOCs) per year (p &lt; .001). Diastolic function, E/A of LV, and RV were negatively correlated to the hemoglobin and serum ferritin levels. Conclusions The TGF‐β, IL‐18, and LDH along with frequent VOCs are correlated to altered LS, especially the right ventricle, and could serve as risk indicators for subclinical cardiomyopathy in children with SCD.</abstract><cop>Glenview</cop><pub>Wiley Subscription Services, Inc</pub><doi>10.1002/pbc.30762</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0001-6822-5597</orcidid><orcidid>https://orcid.org/0000-0003-0738-9306</orcidid></addata></record>
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subjects Cardiomyopathy
Children
deformed myocardium
Echocardiography
Ferritin
Hematology
Hemoglobin
Morbidity
Myocardium
Oncology
Pediatrics
sickle cell cardiomyopathy
Sickle cell disease
speckle tracking echocardiography
strain
TGF‐β and IL‐18
tissue Doppler imaging
Transforming growth factor-b
Ventricle
title Altered ventricular longitudinal strain in children with sickle cell disease: Role of TGF‐β and IL‐18
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