Author + information
- Adebayo Atandaa,b,
- Yahya Aliyua,b,
- Oluwafunmilayo Atandaa,b,
- Aliyu Babadokoa,b,
- Aisha I. Mammana,b and
- Zakari Y. Aliyua,b
Background: Various papers on sickle cell disease (SCD) in the USA reveals cardiac dysfunction. However, the highest burden of SCD is in Sub Saharan Africa. Amidst this population, use of hydroxyurea, blood transfusion and iron overload is extremely limited, allowing for a unique assessment of biventricular function.
Method: We evaluated 208 hydroxyurea naive consecutive SCD patients aged 10-52 years at steady state and 94 healthy non-matched controls who were studied in Nigeria in a cross-sectional manner. SCD patients were required to have electrophoretic and or liquid chromatography documentation of major sickling phenotypes. Control group was required to have non-sickling phenotype. Cardiac measurements were performed with transthoracic echo (TTE) for both systolic and diastolic functions according to American Society of Echocardiography guidelines.
Results: Patients with SCD had significantly higher mean±SD values for tricuspid regurgitant jet velocity than did the controls (2.1±0.6 vs. 1.8±0.5; p<0.001). 25% of SCD patients had elevated systolic pulmonary artery pressure (PAP) as defined by jet velocity ≥2.5 m/s(estimated systolic PAP ≥30 mm Hg) compared to 7% of controls (P<0.001). 4% had jet velocities ≥3.0 (estimated systolic PAP≥41) compared to 0% controls. Compared to controls, SCD patients had significantly higher values of left ventricular (LV) size; there was no qualitative evidence of systolic dysfunction, ejection fraction (EF) ≤0.5). The patients had significant higher values of EF and E/A ratio. In SCD group, there was no clear pattern of worsening diastolic function with increased Tricuspid Regugitant Volume. Also, E/A had a significant positive relationship with jet velocity in bivariate analysis (R=0.20; P=0.013).
Conclusions: Overall, this shows that prevalence of pulmonary hypertension in Nigerian patients is independent of concomitant LV systolic or diastolic dysfunction.
African SCD patients provide a unique population for evaluation of LV dysfunction from an epidemiological and clinical perspective. We established that while pulmonary hypertension is prevalent in this population the biventricular functions are preserved in contrast to patients in the USA.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Novel Echocardiographic Methods for Assessing Cardiac Function
Abstract Category: 28. Non Invasive Imaging: Echo
Presentation Number: 1120-236
- 2017 American College of Cardiology Foundation