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Pediatr Blood Cancer. 2015 Jul;62(7):1228-31. doi: 10.1002/pbc.25456. Epub 2015 Mar 2.

Abnormal circumferential strain measured by echocardiography is present in patients with Shwachman-Diamond syndrome despite normal shortening fraction.

Author information

1
The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
2
Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
3
Department of Medicine, University of Washington, The Severe Chronic Neutropenia International Registry, Seattle, Washington.
4
Department of Medicine, University of Washington, Seattle, Washington.
5
Puget Sound Blood Center, Seattle, Washington.
6
Department of Pediatrics, University of Washington, Seattle, Washington.
7
Seattle Children's Hospital, Seattle, Washington.
8
Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.

Abstract

BACKGROUND:

Shwachman-Diamond Syndrome (SDS) is an autosomal recessive disorder characterized by bone marrow failure and exocrine pancreatic dysfunction. Heart failure has been described in patients with SDS. Circumferential strain (ε(cc)) is a measure of cardiac performance that may identify dysfunction when standard measures are normal.

PROCEDURES:

Patients with SDS were identified and the echocardiographic database queried. Cardiac anatomy and function were recorded, and ε(cc) was measured retrospectively.

RESULTS:

From 1995-2013, 27 patients with biallelic SBDS mutations confirming the diagnosis of SDS were identified at our institution: 14 had at least one echocardiogram available; 10 underwent HSCT, with echocardiograms available in nine. Ejection fraction (EF) was normal in all 14 patients evaluated; however, ε(cc) was decreased in 4/12 studies prior to HSCT. In two patients, ε(cc) was abnormal both before and after HSCT, in one, ε(cc) changed from normal to abnormal after HSCT, and in one, ε(cc) was normal after HSCT despite being abnormal prior. Echocardiogram reports were also available for six patients in the North American SDS registry, all with normal EF.

CONCLUSIONS:

While EF was normal in all patients with SDS, ε(cc) was abnormal in 33% prior to HSCT and 33% of those who had undergone HSCT. This suggests that SDS is associated with systolic dysfunction. Further studies are needed to define the incidence of dysfunction in this group and the progression to heart failure.

KEYWORDS:

Shwachman-Diamond syndrome (SDS); cardiomyopathy; echocardiography; heart failure; hematopoietic stem cell transplant

PMID:
25732529
PMCID:
PMC4819242
DOI:
10.1002/pbc.25456
[Indexed for MEDLINE]
Free PMC Article

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