Evaluation of Tp-e Interval and Tp-e/QTc Ratio among Patients with Steady State Sickle Cell Disease

Abstract

Sickle cell disease (SCD) has been regarded as an inflammatory and pro- coagulatory disease with profound cardiovascular abnormalities including propensity for ventricular arrhythmogenesis. Tp-e and Tpe/QTc ratio however has been proposed as better indicators of arrythmogenesis and has been shown to be prolonged in many inflammatory conditions and correlate with levels of inflammatory markers. However, correlation between Tpe/QTc ratio and the level of highly sensitive C-reactive protein (hs-CRP) and plasminogen activator inhibitor (PAI) have not been reported in SCD. This study aims at evaluating Tp-e Interval and Tp-e/QTc ratio among steady state Sickle cell disease patients in relationship to the degree of anaemia, inflammatory and profibrotic markers. Methodology: A cross-sectional hospital-based study comprises 30 sickle cell anaemia patients in steady state with an equal number of controls having genotype HbAA and HbAS respectively.Clinical, laboratory and ECG parameters were obtained. Results: A total of 90 participants are with mean age 24.2 ± 5.6. The study showed that sickle cell disease patient had significantly lower level of PCV and higher level of PAI, platelet and total white cell count (p value < 0.05). C-reactive protein was also higher in them. 76.7% of HbSS patients had abnormal ECG. QTc and Tp-e were also prolonged in sickle cell disease patients compared with controls. An association was found between the level of PCV, PAI and prolonged Tp-e and QTc. Conclusion: Sickle cell disease patients have higher levels of inflammatory markers and abnormal ECG patterns are common in them. Moreover, the levels of these inflammatory markers correlate with Tp-e parameters.