TY - JOUR
T1 - Pulmonary hypertension and right ventricular function in Nigerian children with sickle cell anaemia
AU - Peter, Igoche D.
AU - Asani, Mustafa O.
AU - Abdullahi, Shehu U.
AU - Aliyu, Ibrahim
AU - Obaro, Stephen K.
AU - Bode-Thomas, Fidelia
N1 - Funding Information:
Funding: This work was supported by the National Institute of Allergy and Infectious Diseases of the National Institutes of Health (award R01A1097493 to Stephen K. Obaro) and the Bill & Melinda Gates Foundation (award OPP1034619 to Stephen K. Obaro). The content is solely the responsibility of the authors and does not represent the official views, positions or policies of these entities.
Publisher Copyright:
© 2019 The Author(s) 2019. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.
PY - 2019/8/1
Y1 - 2019/8/1
N2 - Background: Pulmonary hypertension (PH), a complication of sickle cell anaemia (SCA), results in considerable morbidity. This study aims to determine the prevalence and associations of echocardiography-suggested PH in children with SCA. Methods: We performed a cross-sectional comparative study involving 100 systematically sampled SCA subjects 3-14 y of age in their steady state with matched haemoglobin AA phenotype controls. Clinical, laboratory and echocardiography data (including tricuspid regurgitation velocity [TRV], mean pulmonary arterial pressure [mPAP] and tricuspid annular plane systolic excursion [TAPSE]) were obtained from all patients. Statistical analyses were performed using SPSS version 22 (IBM, Armonk, NY, USA). A p-value <0.05 was considered statistically significant. Results: Of the 100 SCA subjects studied, 22 (22%) had echocardiographic findings suggestive of PH compared with none in the controls. The median TAPSE was significantly lower in the PH group (2.55 cm [interquartile range {IQR} 2.2-2.8]) compared with the no PH group (2.77 cm [IQR 2.4-3.2]) (p=0.03). No significant correlation existed between mPAP and age, nor any laboratory parameters studied. The odds ratio (OR) suggested PH significantly increased with an increase in the frequency of hospitalizations for vaso-occlusive crises within a 12-month period (OR 15.15 [95% CI 1.57 to 146.35], p=0.02) and a lifetime history of blood transfusion (OR 5.44 [95% CI 1.09 to 27.24], p=0.04). Conclusions: Echocardiography-suggested PH is common in children with SCA and is associated with poorer right ventricular function, frequent vaso-occlusive crises and blood transfusions.
AB - Background: Pulmonary hypertension (PH), a complication of sickle cell anaemia (SCA), results in considerable morbidity. This study aims to determine the prevalence and associations of echocardiography-suggested PH in children with SCA. Methods: We performed a cross-sectional comparative study involving 100 systematically sampled SCA subjects 3-14 y of age in their steady state with matched haemoglobin AA phenotype controls. Clinical, laboratory and echocardiography data (including tricuspid regurgitation velocity [TRV], mean pulmonary arterial pressure [mPAP] and tricuspid annular plane systolic excursion [TAPSE]) were obtained from all patients. Statistical analyses were performed using SPSS version 22 (IBM, Armonk, NY, USA). A p-value <0.05 was considered statistically significant. Results: Of the 100 SCA subjects studied, 22 (22%) had echocardiographic findings suggestive of PH compared with none in the controls. The median TAPSE was significantly lower in the PH group (2.55 cm [interquartile range {IQR} 2.2-2.8]) compared with the no PH group (2.77 cm [IQR 2.4-3.2]) (p=0.03). No significant correlation existed between mPAP and age, nor any laboratory parameters studied. The odds ratio (OR) suggested PH significantly increased with an increase in the frequency of hospitalizations for vaso-occlusive crises within a 12-month period (OR 15.15 [95% CI 1.57 to 146.35], p=0.02) and a lifetime history of blood transfusion (OR 5.44 [95% CI 1.09 to 27.24], p=0.04). Conclusions: Echocardiography-suggested PH is common in children with SCA and is associated with poorer right ventricular function, frequent vaso-occlusive crises and blood transfusions.
KW - Nigeria
KW - children
KW - pulmonary hypertension
KW - sickle cell anaemia
KW - tricuspid annular plane systolic excursion
KW - tricuspid regurgitant velocity
UR - http://www.scopus.com/inward/record.url?scp=85071053089&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85071053089&partnerID=8YFLogxK
U2 - 10.1093/trstmh/trz038
DO - 10.1093/trstmh/trz038
M3 - Article
C2 - 31086994
AN - SCOPUS:85071053089
VL - 113
SP - 489
EP - 496
JO - Transactions of the Royal Society of Tropical Medicine and Hygiene
JF - Transactions of the Royal Society of Tropical Medicine and Hygiene
SN - 0035-9203
IS - 8
M1 - trz038
ER -