Electocardiographic findings in adult Nigerians with sickle cell anaemia (original) (raw)
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Electrocardiographic Study in Adult Homozygous Sickle Cell Disease Patients in Lagos, Nigeria
Journal of Tropical Medicine, 2016
Background. This study sought to identify the pattern of electrocardiographic changes in steady state adult sickle cell anaemia.Methods.A case-control, cross-sectional study was conducted amongst sickle cell patients attending the sickle cell clinic of Lagos State University Teaching Hospital, Ikeja, and HbAA controls. All consenting participants had haemoglobin electrophoresis done and were subjected to electrocardiography (ECG). The descriptive data were given as means ± standard deviation (SD). The differences were considered to be statistically significant when thepvalue obtained was <0.05.Results.A total of ninety-three sickle cell anaemia (SCA) patients and ninety haemoglobin AA (controls) were enrolled. There was no significant difference in the age of the participants with SCA and that of the controls but the body mass index was significantly higher in controls (p=0.0001). Overall, 73.1% (68 of 93) had abnormal ECG while only 2 of 90 (2.2%) of controls had abnormal ECG. T...
2015
Sickle cell anemia is a genetic blood disorder affecting mostlyAfricans, Hispanics, Indians and people of Middle Easterndescent; involving major organs of which the heart is the mostfatal and commonest cause of morbidity and mortality. Thepresent study aims to determine some electrocardiographicparameters of sickle cell anemia children attending the sicklecell clinic at the University of Port Harcourt Teaching Hospital, Port Harcourt,Nigeria. A total of 118 subjects comprising of 55 sickle cell anemia (HbSS genotype) patients (Group A) and 63 normal controls consisting of 40 subjects (HbAA genotype) Group B and 23 subjects (HbAS genotype) Group C were recruited into the study. Control subjects were matched for weight and sex with sickle cell anemia (HbSS genotype) (Group A) patients. All subjects were aged between 2 and 15years. Height, weight, body mass index, hemoglobin concentration and heart rates were determined and a thorough physical examination conducted to exclude the prese...
African Health Sciences, 2017
Background: Reliable diagnostic measures for the evaluation of left ventricular systolic performance in the setting of altered myocardial loading characteristics in sickle cell anaemia remains unresolved. Objective: The study was designed to assess left ventricular systolic function in adult sickle cell patients using non-invasive endsystolic stress-end-systolic volume index ratio. Methods: A descriptive cross sectional comparative study was done using 52 patients recruited at the adult sickle cell anaemia clinic of the University of Nigeria Teaching Hospital Enugu. An equal number of age and sex-matched healthy volunteers served as controls. All the participants had haematocrit estimation, haemoglobin electrophoresis, as well as echocardiographic evaluation. Result: The mean age of the patients and controls were 23.93 ± 5.28 (range 18-42) and 24.17 ± 4.39 (range 19-42) years respectively, (t = 0.262; p= .794). No significant difference was seen in estimate of fractional shortening, and ejection fraction. The cardiac output , cardiac index and velocity of circumferential shortening were all significantly increased in the cases compared with the controls. The end systolic stress-end systolic volume index ratio (ESS/ESVI) was significantly lower in cases than controls. There were strong positive correlation between the ejection phase indices (ejection fraction and fractional shortening) and end systolic stress and ESS/ESVI. Conclusion: The study findings suggest the presence of left ventricular systolic dysfunction in adult sickle cell anaemia. This is best detected using the loading-pressures independent force-length relationship expressed in ESS/ESVI ratio.
cureus, 2021
Introduction Sickle cell anemia (SCA) in adults has many clinical manifestations. These manifestations are due to effects of recurrent hemolysis, anemia, and ischemia-reperfusion injury on various organs, including the heart. These factors determine the severity of the disease. Objectives The aim of the study was to assess the severity of SCA using a scoring system consisting of clinical and laboratory parameters. In addition, the study aimed to determine the electrocardiographic abnormalities in the adult SCA population. Study design This was a cross-sectional, observational study conducted in the medical outpatient clinic of Irrua Specialist Teaching Hospital, Irrua, Nigeria. Methodology Sixty SCA patients who were older than 18 years old were recruited for this study between February 2017 and January 2018. Sixty healthy individuals matched for age and sex were recruited to serve as controls. Patients who were pregnant or having an acute crises were excluded from the study. Each participant had an electrocardiogram and a SCA severity score was calculated using their clinical history and complete blood count. Data analysis was carried out using the IBM Statistical Package for Social Sciences Statistics® software, version 21 (IBM SPSS Statistics for Windows, Armonk, NY) and statistical significance assigned to p-values less than 0.05. Results Severity scores for SCA ranged between 7 and 24, with a mean score of 14.5 ± 4.04. Out of the 60 patients, 14 (23.3%), 39 (65%), and seven (11.7%) participants met criteria for mild, moderate, and severe disease, respectively. Tachycardia, prolonged QTc, and the presence of ST segment and T-wave abnormalities were significantly associated with severe SCA (p = 0.024, p = 0.027, and p = 0.018, respectively). There was positive correlation between SCA severity scores and P-wave duration (r = 0.327, p = 0.011), QRS dispersion (r = 0.298, p = 0.021), QTc interval (r = 0.332, p = 0.010), and QTc dispersion (r = 0.320, p = 0.013). Conclusion This study demonstrated that moderate and severe forms of SCA are common in our region. Tachycardia, left atrial abnormality, prolonged corrected QT interval, and the presence of ST-segment and T-wave changes are electrocardiographic findings associated with more severe forms of the disease. These abnormalities are significant etiologies of cardiac morbidity and mortality in SCA.
Background: Abnormal electrocardiogram (ECG) is common in children with sickle cell anemia (SCA). There are three levels of SCA severity, and the severe form is fatal. However, whether SCA severity level is associated with abnormal ECG is unknown. Aim: To determine the relationship between SCA disease severity and abnormal ECG during steady-state. Method: This cross-sectional study recruited 56 SCA patients between 4 and 17 years of age. Patients' clinical information was obtained, and a physical examination with a full blood count was performed. These data were used to classify SCA in the subjects according to their severity as mild, moderate, or severe. 12-lead electrocardiography was performed after the physical examination. Results: The median (interquartile) disease severity score was 4.0 (3.0-6.5), with a range of 1-19. Most subjects (78.6%) had mild disease, while 14.3% and 7.1% had moderate and severe disease, respectively. T-wave changes were the most prevalent (55.4%) ECG abnormality. None of the ECG abnormalities were significantly related to disease severity. However, prolonged QTc interval correlated negatively with disease severity (r=-0.272, p=0.043). Two or more ECG abnormalities per subject were observed in 53.6% of those with mild disease. Conclusion: All three disease severity levels are associated with abnormal ECG patterns, especially T-wave changes. The predominance of mild disease in the investigated locality may be why prolonged QTc interval and multiple ECG abnormalities were mainly observed in them. Routine electrocardiography may be done to identify at-risk patients for further cardiac management.
Assessment of Right Ventricular Function in Children with Sickle Cell Anaemia Seen in Enugu, Nigeria
2020
Background: Sickle cell anaemia (SCA) is characterized by attendant ischemia-reperfusion injury especially to the heart. Objectives: To compare the right ventricular function of children with SCA in steady state (subjects) with those with haemoglobin AA genotype (controls), using echocardiography. Methods: The cross-sectional study utilized 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%, (χ 2 =8.5, p=0.0035). A higher proportion of subjects with sickle cell anaemia (25.5%) had Pulmonary hype...
Journal of Evolution of medical and Dental Sciences, 2021
BACKGROUND Sickle cell disease is the commonest haemoglobinopathy. Recent advanced therapeutic approaches are enabling the sickle cell patients to survive beyond adulthood. METHODS The study provides important data on cardiovascular abnormalities in sickle cell disorder in Chhattisgarh by employing a non-invasive method of two-dimensional colour Doppler echocardiography. RESULTS The present study suggests that sickle cell disease has association with left ventricular diastolic dysfunction and pulmonary artery hypertension and no association with other echocardiographic findings including left ventricular dimensions and functions. The association is further affected by the presence of moderate to severe anaemia (haemoglobin < 8.9 gm %), higher urea (> 19 mg / dL), creatinine (0.8 mg / dL) and diastolic blood pressures (< 69 mmHg). The age, gender and systolic blood pressures of the subject were not found to impact echocardiographic parameters. CONCLUSIONS The present study s...
The sickle cell disease has high prevalence in India. The increased lifespan of sickle patients has facilitated to study its cardiovascular effects. The present study documents the electrocardiogram indices between the sickle cell and non-sickle cell subjects from Chhattisgarh state. The study concludes a significant increase in PR interval, corrected QT interval, left ventricular hypertrophy and biventricular hypertrophy and no difference in heart rate and rhythm, ventricular axis and right ventricular dimensions. These observations can be attributed to increased cardiac output on left ventricular dimensions and effect of microinfarcts on myocardial
Medical Science and Discovery, 2021
Objective: The prevalence and burden of Sickle Cell Anaemia (SCA) in Nigeria are high and they contribute to childhood morbidity and mortality. Chronic anaemia and vaso-occlusion usually involve different organs. The involvement of the heart is a common complication of SCA, thus the need for early detection of cardiac abnormalities in children with SCA. To assess cardiac structure using ECG in children with SCA in steady-state and to determine the relationship between abnormal ECG findings and the participants’ haemoglobin concentration. Material and Method: It was a cross-sectional study done in one of the tertiary hospitals in southeast Nigeria. The study participants were 164 children with SCA in steady state within the ages of 2 -17 years. A 12-lead ECG was carried out on the participants and their haemoglobin concentrations determined. The relationship between the presence of cardiac abnormality and independent variables like haemoglobin concentration, age and gender were anal...
Echocardiographic Characteristics of Patients with Sickle Cell Anaemia in Sergipe, Brazil
Journal of Tropical Pediatrics, 2001
This study describes the cardiac size and function of patients with sickle cell anaemia, in Segipe, Brazil, and its association to the clinical severity, duration of illness and haemoglobin levels. Heart measurements were obtained by echocardiography from 38 children and adolescents and compared to international reference values. Sickle cell patients had increased left atrial and ventricular dimensions in systole and an increased end diastolic septal and left ventricular free wall thickness. These findings correlated with age. There were no abnormalities in the ejection or shortening fractions. These results suggest early haemodynamic changes with progressive cardiac chamber dilation and diastolic dysfunction that become increasingly abnormal with growth.