Pulmonary hypertension in Nigerian adults with sickle cell anemia

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:

• pulmonary hypertension
• Nigerian adults
• sickle cell anemia
• doppler-derived

Acknowledgments

The significant contributions of Prof AO Fatusi, who was, at the time the study was conducted, the head of the Institute of Public Health of Obafemi Awolowo University, Ile-Ife, Nigeria, in offering statistical advice are very much appreciated. This work was carried out in the Cardiac Care Unit and Department of Haematology and Blood Transfusion of the OAUTHC, Ile-Ife, Osun State, Nigeria. This work was supported by the management of OAUTHC, Ile-Ife, Osun State, Nigeria.

Disclosure

The authors report no conflicts of interest in this work.