Noninvasive assessment of systolic and diastolic left ventricular function in patients with chronic severe anemia: A combined M-mode, two-dimensional, and Doppler echocardiographic study

V. K. Bahl, O. P. Malhotra, D. Kumar, R. Agarwal, K. C. Goswami, R. Bajaj, S. Shrivastava

Research output: Contribution to journalArticle

51 Scopus citations

Abstract

Thirty-one patients with chronic severe anemia of more than 3 months' duration (hemoglobin less than 7 gm/dl) and no underlying heart disease were studied by means of M-mode, two-dimensional, and Doppler echocardiography; and equal number of normal control subjects was also studied. There are conflicting reports regarding the influence of chronic severe anemia on systolic myocardial function, but diastolic function has not been systematically assessed. It is also uncertain whether anemia alone can cause heart failure in a structurally normal heart. We therefore performed a detailed study of echocardiographic indexes of systolic and diastolic left ventricular function in these patients. We found that patients with anemia have significantly faster heart rates and lower diastolic and mean blood pressures than normal subjects. They also have a significantly elevated cardiac output and stroke volume and larger left ventricles. Left ventricular contractility, assessed by the end-systolic stress-dimension relationship, was enhanced. There was no systematic evidence of diastolic dysfunction by Doppler assessment of mitral inflow. There was also no clinical evidence of congestive heart failure. We conclude that chronic severe anemia leads to a hyperdynamic state with systolic hyperfunction and no impairment of diastolic function. Anemia does not lead to congestive heart failure in the absence of underlying heart disease.

Original languageEnglish (US)
Pages (from-to)1516-1523
Number of pages8
JournalAmerican Heart Journal
Volume124
Issue number6
DOIs
StatePublished - Dec 1992
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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