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Right ventricular function among South East Nigeria children with sickle cell anaemia
Josephat M Chinawa1, Bartholomew F Chukwu2, Awoere T Chinawa3
1Department of Paediatrics, College of Medicine, University of Nigeria Enugu Campus, Enugu, Nigeria.
Insights
Children with sickle cell anaemia (SCA) exhibit higher rates of right ventricular dysfunction, including systolic and diastolic issues and pulmonary hypertension. Echocardiography revealed significant differences compared to healthy children.
Area of Science:
- Pediatric Cardiology
- Hematology
- Cardiovascular Research
Background:
- Sickle cell anaemia (SCA) is linked to ischemia-reperfusion injury, particularly affecting the heart.
- Understanding cardiac complications in SCA is crucial for patient management.
Purpose of the Study:
- To compare right ventricular function in children with SCA during steady state versus healthy controls.
- To assess echocardiographic parameters of right ventricular function in pediatric SCA patients.
Main Methods:
- A cross-sectional study design was employed.
- Echocardiography was used to measure right ventricular function parameters.
- Children with SCA (subjects) were compared to those with haemoglobin AA genotype (controls).
Main Results:
- Right ventricular dysfunction was significantly more prevalent in children with SCA (50.0%) compared to controls (22.0%).
- Pulmonary hypertension (25.5%) and diastolic dysfunction (9.8%) were also significantly higher in SCA patients.
- Mean transannular plane systolic excursion (TAPSE) was statistically higher in SCA subjects, though a higher proportion showed dysfunction.
Conclusions:
- Children with sickle cell anaemia demonstrate impaired right ventricular function.
- SCA patients exhibit increased prevalence of both systolic and diastolic right ventricular dysfunction.
- Pulmonary hypertension is a significant comorbidity in children with SCA.
Background:
Sickle cell anaemia (SCA) is characterized by attendant ischemia-reperfusion injury especially to the heart.
Methods:
The aim of this work is to compare the right ventricular function of children with SCA in steady state (subjects) with those with haemoglobin AA genotype (controls), using echocardiography. It is a cross-sectional study, which echocardiographic measurements to assess right ventricular function among children with SCA and their controls.
Results:
The mean trans annular plane systolic excursion (TAPSE) in subjects, 28.24 ± 5.23 (Z score: 0.258 ± 1.10) was higher than that in control, 25.82 ± 3.59 (Z score: - 0.263 ± 0.80), and the difference in mean was statistically significant, (t = 2.703, p = 0.008). Significantly higher proportion of subjects with sickle cell anaemia had right ventricular dysfunction (Abnormal TAPSE), 25 (50.0%) when compared with those in control, 11 (22.0%), {χ2 = 8.5, p = 0.0035}. A higher proportion of subjects with sickle cell anaemia (25.5%) had Pulmonary hypertension (RVP) when compared with control (2.0%) and the difference in proportions was found to be statistically significant, (χ2 = 11.668, p = 0.001). The prevalence of right ventricular diastolic dysfunction in subjects was 9.8% while control was 0%.
Conclusion:
Children with sickle cell anaemia present with right ventricular dysfunction. Prevalence of right ventricular systolic and diastolic dysfunction were higher in subjects. More of the subjects in this study (25.5%) had pulmonary hypertension.
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