Pulmonary hypertension in Nigerian adults with sickle cell anemia

Vasc Health Risk Manag. 2017 May 8:13:153-160. doi: 10.2147/VHRM.S92799. eCollection 2017.

Abstract

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: Nigerian adults; doppler-derived; pulmonary hypertension; sickle cell anemia.

MeSH terms

  • Adolescent
  • Adult
  • Anemia, Sickle Cell / diagnosis
  • Anemia, Sickle Cell / epidemiology*
  • Arterial Pressure*
  • Echocardiography, Doppler
  • Exercise Tolerance*
  • Female
  • Hospitals, University
  • Humans
  • Hypertension, Pulmonary / diagnosis
  • Hypertension, Pulmonary / epidemiology*
  • Hypertension, Pulmonary / physiopathology
  • Male
  • Nigeria / epidemiology
  • Prevalence
  • Pulmonary Artery / physiopathology*
  • Tricuspid Valve / physiopathology
  • Tricuspid Valve Insufficiency / epidemiology
  • Tricuspid Valve Insufficiency / physiopathology
  • Walk Test
  • Young Adult