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Echocardiographic abnormalities in adolescent and adult Saudi patients with sickle cell disease
Aamer Aleem1, Ahmed Jehangir, Mohammad Owais
1Department of Medicine (38), College of Medicine & King Khalid University Hospital, PO Box 7805, Riyadh 11472, Kingdom of Saudi Arabia. aameraleem@hotmail.com
Insights
Cardiac abnormalities are common in Saudi sickle cell disease (SCD) patients, with pulmonary hypertension being the most frequent finding. Echocardiography revealed other cardiac issues in a significant proportion of individuals studied.
Area of Science:
- Cardiology
- Hematology
- Public Health
Background:
- Cardiovascular complications are recognized in sickle cell disease (SCD).
- Cardiac involvement in Saudi SCD patients remains understudied.
Purpose of the Study:
- To identify cardiac abnormalities using echocardiography in adolescent and adult Saudi patients with stable SCD.
- To assess the prevalence and types of cardiac involvement in this population.
Main Methods:
- Prospective echocardiographic study of 65 Saudi SCD patients.
- Evaluation of chamber dimensions, ventricular function, valvular anomalies, and pulmonary artery pressure.
- Comparison with age and gender-matched controls and correlation with hematological data.
Main Results:
- Pulmonary hypertension (PH) was the most common abnormality, found in 38% of patients.
- Other findings included dilated atria (26-20%), dilated left ventricle (15%), valvular anomalies (32%), and reduced ejection fraction (6%).
- Older age, lower fetal hemoglobin, and high serum ferritin correlated with increased pulmonary artery systolic pressure.
Conclusions:
- A significant proportion of Saudi SCD patients exhibit cardiac abnormalities.
- Pulmonary hypertension is the predominant cardiac finding, with other abnormalities being less frequent.
Objective:
Cardiovascular complications in sickle cell disease (SCD) have been well documented but cardiac involvement in Saudi patients with SCD is not known. We sought to identify cardiac abnormalities by echocardiography in adolescent and adult Saudi patients with stable SCD.
Methods:
Sixty-five consecutive patients with SCD followed at King Khalid University Hospital, Riyadh, were prospectively studied from January 2005 to December 2005. All patients underwent echocardiographic examination to determine chamber dimensions, left ventricular function, valvular anomalies and pulmonary artery pressure. Data were compared to normal age and gender-matched controls. Hematological data were also collected from the patients and correlated with the echocardiographic results.
Results:
Twenty-eight males and 37 females were evaluated. The mean age of the group was 24.5+/-9.2 (range 14-44) years. The most common abnormality found was pulmonary hypertension (PH) present in 25 (38%) patients. The majority of these patients had mild PH and only 6 (9%) patients had pulmonary artery systolic pressure (PASP) more than 40 mm Hg. Older age, lower level of fetal hemoglobin and high serum ferritin were associated with increased PASP. Other abnormalities present included dilated left atrium in 17 (26%) patients, dilated right atrium 13 (20%), dilated left ventricle 10 (15%), valvular anomalies 21 (32%) and reduced ejection fraction in 4 (6%) patients.
Conclusion:
Cardiac abnormalities are found in a significant proportion of Saudi patients with SCD. Pulmonary hypertension is the most common finding while other abnormalities are less frequent.
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