Pulmonary hypertension and right ventricular function in the sickle cell
populace
Abstract
Sickle cell anaemia(SCA) is a recognized cause of heart failure and
pulmonary hypertension(PHT). However, the impact of PHT of right
ventricular(RV) function has not been well elucidated. Objective To
determine the impact of PHT on right ventricular function in patients
with SCA. Methods Cases were adults with SCA with PHT. Controls were SCA
patients without pulmonary hypertension. All patients were recruited in
steady-state. Echocardiography was done for cases and controls. Measures
of RV function used were RV fractional area change (RV FAC), peak
tricuspid annular systolic velocity (Sʹ) and Tricuspid annular plane
systolic excursion (TAPSE). Pulmonary hypertension was estimated from
Tricuspid regurgitation jet velocities. Right atrial pressure was
estimated using the ratio of the Trans tricuspid early diastolic
velocity to the early tissue doppler diastolic velocity of the tricuspid
annulus. Values >35mmHg were said to have PHT. Results Out
of 86 patients, there were 36 people with SCA that had tricuspid
regurgitation- 11 with PHT, 25 without PHT. The mean values of RV
systolic function- RV FAC (0.41SD0.1 vs 0.41SD0.1; p= 0.999), Sʹ
(16.5SD5.1 vs 15.9SD4.3; p= 0.116) and TAPSE (30.7SD5 vs 29.7SD4.3;
p=0.389) were not significantly different between cases and controls
respectively. Trans tricuspid E/A ratio (1.49SD0.4 vs 1.61SD0.4;
p=0.381) was essentially the same between both groups while the early
trans tricuspid deceleration time showed a trend towards being shorter
in those with PHT (194.1SD35.1vs 223.3SD53.6; p=0.084). Conclusion: The
prevalence of PHT was 12.8% in SCA patients. There is no significant
impact of PHT on RV function in SCA.