Pulmonary hypertension and right ventricular function in Nigerian children with sickle cell anaemia

Igoche D. Peter, Mustafa O. Asani, Shehu U. Abdullahi, Ibrahim Aliyu, Stephen K. Obaro, Fidelia Bode-Thomas

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Article numbertrz038
Pages (from-to)489-496
Number of pages8
JournalTransactions of the Royal Society of Tropical Medicine and Hygiene
Volume113
Issue number8
DOIs
StatePublished - Aug 1 2019

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Right Ventricular Function
Sickle Cell Anemia
Pulmonary Hypertension
Echocardiography
Odds Ratio
Blood Transfusion
Arterial Pressure
Tricuspid Valve Insufficiency
Lung
Hospitalization
Cross-Sectional Studies
Morbidity
Phenotype

Keywords

  • Nigeria
  • children
  • pulmonary hypertension
  • sickle cell anaemia
  • tricuspid annular plane systolic excursion
  • tricuspid regurgitant velocity

ASJC Scopus subject areas

  • Parasitology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

Pulmonary hypertension and right ventricular function in Nigerian children with sickle cell anaemia. / Peter, Igoche D.; Asani, Mustafa O.; Abdullahi, Shehu U.; Aliyu, Ibrahim; Obaro, Stephen K.; Bode-Thomas, Fidelia.

In: Transactions of the Royal Society of Tropical Medicine and Hygiene, Vol. 113, No. 8, trz038, 01.08.2019, p. 489-496.

Research output: Contribution to journalArticle

Peter, Igoche D. ; Asani, Mustafa O. ; Abdullahi, Shehu U. ; Aliyu, Ibrahim ; Obaro, Stephen K. ; Bode-Thomas, Fidelia. / Pulmonary hypertension and right ventricular function in Nigerian children with sickle cell anaemia. In: Transactions of the Royal Society of Tropical Medicine and Hygiene. 2019 ; Vol. 113, No. 8. pp. 489-496.
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abstract = "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.",
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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

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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

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KW - tricuspid annular plane systolic excursion

KW - tricuspid regurgitant velocity

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