Background:Sickle cell disease (SCD) is a major health problem that affects over 20 million people worldwide with over a billion dollars spent annually in the United States (US) itself to cover healthcare costs. Approximately 300,000 children are born annually with SCD at least 75% of them are in Africa. SCD affects about 1 in 500 African Americans and nearly 1 in 12 African Americans carry the autosomal recessive gene. It is estimated that there are almost 100,000 SCD patients in the United States. Speckle-tracking echocardiography (STE) is a new noninvasive ultrasound imaging technique that allows for an objective and quantitative evaluation of the global and regional function of atrial and ventricular chambers. Although in almost all patients with SCD, coronary angiography reveals normal coronary arteries, yet myocardial ischemia and infarction have been reported to occur in SCD. Some SCD patients have marked abnormalities in exercise capacity and cardiac filling abnormalities