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Original Research | Cardiology Science | Volume 15 Issue 6, June 2026 | Pages: 382 - 387 | India
Left Ventricular Global Longitudinal Strain as a Predictor of Silent Myocardial Dysfunction in Asymptomatic Adult Patients with Sickle Cell Disease (HbSS) with Preserved Ejection Fraction
Abstract: Background: Sickle cell disease (SCD) is associated with progressive cardiovascular damage due to many contributing factors such as chronic haemolytic anaemia, repeated microvascular ischaemia, and excess iron deposition. Left ventricular ejection fraction (LVEF), the conventional index of systolic function, lacks sensitivity for early subclinical myocardial injury. Left ventricular global longitudinal strain (LV-GLS) derived from 2-D speckle-tracking echocardiography (2D-STE) quantifies myocardial longitudinal deformation and detects dysfunction before actual LVEF falls. Objectives: To assess LV-GLS as a predictor of silent myocardial dysfunction in asymptomatic adult HbSS patients with preserved LVEF, and to correlate GLS with laboratory markers of disease severity. Methods: A prospective cross-sectional study enrolled 50 asymptomatic adult HbSS patients (mean age 29.1 ± 6.8 years; 29 male, 21 female) with LVEF ≥50% and 30 healthy age- and sex-matched controls at GMC & SSH Nagpur (November 2024?October 2025). Standard 2D-TTE and STE were performed. LV-GLS was derived from three apical views. Abnormal GLS was defined as > -20%. Results: Sixty-two percent (31/50) of HbSS patients had impaired LV-GLS (> -20%) with preserved LVEF. Mean LV-GLS was -18.2 ± 2.3% in SCD vs. -20.6 ± 2.0% in controls (p < 0.001). LVEF was comparable (63.1 ± 4.3% vs. 65.4 ± 3.9%; p = 0.07). GLS correlated with haemoglobin (r = 0.52, p < 0.001), LDH (r = -0.47, p < 0.001), and ferritin (r = -0.43, p = 0.002). ROC analysis: AUC 0.83, optimal cutoff GLS > -19.1% (sensitivity 78%, specificity 83%). Conclusion: LV-GLS can be use reveals subclinical LV dysfunction in asymptomatic HbSS patients with normal LVEF. It correlates with haemolytic burden and outperforms conventional echocardiography. GLS screening should be incorporated into cardiac surveillance protocols for adult SCD patients.
Keywords: sickle cell disease, HbSS, global longitudinal strain, speckle-tracking echocardiography, subclinical myocardial dysfunction, silent cardiomyopathy, India
How to Cite?: Dr. Sanket Charpe, Dr. Sonali Gambhire, Dr. Sunil Washimkar, "Left Ventricular Global Longitudinal Strain as a Predictor of Silent Myocardial Dysfunction in Asymptomatic Adult Patients with Sickle Cell Disease (HbSS) with Preserved Ejection Fraction", Volume 15 Issue 6, June 2026, International Journal of Science and Research (IJSR), Pages: 382-387, https://www.ijsr.net/getabstract.php?paperid=SR26607133831, DOI: https://dx.dx.doi.org/10.21275/SR26607133831