Vascular Health and Risk Management (May 2017)
Pulmonary hypertension in Nigerian adults with sickle cell anemia
Abstract
Valentine N Amadi,1 Michael O Balogun,2 Norah O Akinola,3 Rasaaq A Adebayo,2 Anthony O Akintomide2 1Department of Internal Medicine, Federal Medical Centre, Asaba, Delta State, 2Cardiac Care Unit, Department of Medicine, 3Department of Haematology and Blood Transfusion, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria Background: Sickle cell anemia (SCA) is the commonest hemoglobinopathy and is associated with high morbidity and mortality. Pulmonary hypertension (PH) is reported to play a significant role in this regard. There is very limited literature on PH in SCA in Nigeria.Objectives: The objectives of this study were to determine the prevalence of Doppler-derived PH in SCA, assess its influence on exercise capacity, and determine the correlates and predictors of measures of estimated pulmonary pressure.Methods: A total of 92 SCA subjects had echocardiography and 6-minute self-paced walking exercise. PH was diagnosed by Doppler echocardiography on finding a tricuspid regurgitant velocity (TRV) of ≥2.5 m/s. The pulmonary flow profile was also assessed to estimate mean pulmonary arterial pressure (MPAP).Results: Doppler-derived PH was detected in 23.9% of adults with SCA. The 6-minute walking distance (6MWD) was significantly lower in SCA adults with PH than in those without PH (380.33 ± 63.17 m vs 474.28 ± 76.74 m; p = 0.014). TRV and estimated MPAP had a significant inverse correlation with the 6MWD (r = -0.442; p < 0.001 and r = -0.571; p < 0.001, respectively).Conclusion: PH as derived by Doppler is common in Nigerian adults with SCA and has a significantly negative influence on exercise capacity. Screening for PH should be encouraged to optimize management and thus improve their quality of life and life expectancy. Keywords: pulmonary hypertension, Nigerian adults, sickle cell anemia, doppler-derived
