Ventricular hypertrophy and ischaemic changes in Children with Sickle Cell Anaemia and its relationship with the Haemoglobin Concentration in Steady State

Abstract

Objective: The prevalence and burden of Sickle Cell Anaemia (SCA) in Nigeria are high and they contribute to childhood morbidity and mortality. Chronic anaemia and vaso-occlusion usually involve different organs. The involvement of the heart is a common complication of SCA, thus the need for early detection of cardiac abnormalities in children with SCA. To assess cardiac structure using ECG in children with SCA in steady-state and to determine the relationship between abnormal ECG findings and the participants’ haemoglobin concentration.
 Material and Method: It was a cross-sectional study done in one of the tertiary hospitals in southeast Nigeria. The study participants were 164 children with SCA in steady state within the ages of 2 -17 years. A 12-lead ECG was carried out on the participants and their haemoglobin concentrations determined. The relationship between the presence of cardiac abnormality and independent variables like haemoglobin concentration, age and gender were analyzed.
 Result: The prevalence of cardiac abnormality was 59.1%. The commonest cardiac structure abnormality was Left ventricular hypertrophy (LVH) (39.6%). Abnormality in the P-R interval was seen in 14.6%, while ST segment abnormality was seen in 18.3%. The mean Hb of those with abnormal ECG was lower than that of those without abnormal ECG, across each age group. Severe anaemia was a significant (p< 0.01) predictor of LVH. However, there was no significant association between the degree of anaemia and the occurrence of ST-segment (p: 0.26) and PR interval abnormalities (p: 0.52).
 Conclusion: Cardiac anomalies are common findings in SCA children.

Blood pressure and electrocardiographic profile of children with sickle cell anaemia in steady-state and vaso-occlusive crisis

“… 8 , 10 , 16 , 35 Wide variations exist in the prevalence of chamber hypertrophy from different studies, possibly due to variations in other clinical and laboratory parameters that have been shown to influence these changes (steady state haematocrit, sleep and awake oxygen concentrations, use of hydroxyurea.) 36 – 38 which were not all assessed or reported by the various studies.…”