Relationship Between Disease Severity and Resting Electrocardiograms of Adults With Sickle Cell Anemia in a Tertiary Institution in Southern Nigeria

Abstract

Dic-Ijiewere et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Electrocardiographic Changes and Their Association With Disease Severity in Adults With Sickle Cell Anemia at a Tertiary Care Center: A Cross-Sectional Study

“…There was no significant association between the mean age of the study participants or their gender (p = 0.49 and 0.87, respectively). A similar study conducted by Dic-Ijiewere et al among 120 South Nigerian sickle cell cases in 2021 showed 23%, 65%, and 12% of total cases falling under mild, moderate, and severe disease, respectively, with a mean score of 14.5 ± 4.04 [ 13 ]. There was no significant association between severity grade and age groups or gender in the study.…”

“…Dic-Ijiewere et al reported that as the severity of SCA increased, mean P-wave duration, P-wave dispersion, QRS dispersion, QTc interval, and QTc dispersion also increased. For QTc interval and QTc dispersion, these changes were statistically significant (p = 0.003 and p = 0.002, respectively) [ 13 ]. These observations raise suspicion about the metabolic cause of these dispersions secondary to hypoxia or toxins (hyperbilirubinemias).…”

“…This could largely be due to the lack of a universal scoring system for SCA. One such study conducted by Dic-Ijiewere et al showed that there was a significant positive correlation between the SCA severity scores and P-wave duration, P-wave dispersion, QRS dispersion, QTc interval, and QTc dispersion (r: 0.32; p: 0.01; r: 0.27; p: 0.03; r: 0.29; p: 0.02; r: 0.33; p: 0.01; and r: 0.34; p: 0.007, respectively), suggesting a higher risk of left atrial abnormalities, intraventricular conduction abnormalities, increased risk of arrhythmias, and sudden death as disease severity progresses [ 13 ].…”

“…These studies have documented abnormalities such as tachycardia, left ventricular hypertrophy (LVH), left atrial fibrillation, right ventricular hypertrophy (RVH), nonspecific changes of the ST segment and T-wave, arrhythmias (such as ventricular premature complexes and atrial enlargement), prolonged corrected QT intervals, and first-degree atrioventricular block. When compared to normal controls, SCA participants also showed significantly greater mean heart rate, P-wave duration, P-wave dispersion, PR interval, QRS duration, QRS dispersion, QTc interval, and QTc dispersion [ 13 ].…”