Pulmonary hypertension and right ventricular function in the sickle cell populace

Abstract

Background Sickle cell anemia (SCA) is a recognized cause of heart failure and pulmonary hypertension (PHT). However, the effect of PHT of right ventricular (RV) function has not been well elucidated. Objective To determine the effect of PHT on RV function in patients with SCA. Patients and methods Cases were adults with SCA with PHT. Controls were patients with SCA without PHT. All patients were recruited in a steady state. Echocardiography was done according to the recommendation of the American Society for Echocardiography. Measures of RV function used were RV fractional area change, peak tricuspid annular systolic velocity (S′), and tricuspid annular plane systolic excursion. PHT was estimated from tricuspid regurgitation jet velocities. Mean pulmonary arterial pressures more than 20 mmHg were said to have PHT. Results Of 86 patients, 14 had PHT. The mean values of RV systolic function (RV fractional area change, S′, and tricuspid annular plane systolic excursion) were not significantly different between cases and controls. Transtricuspid A was faster, with the E deceleration time shorter in those with PHT. Loud P2, PR interval, and waist–hip ratio (especially in women) correlate directly with PHT, whereas systolic blood pressure, early E deceleration time, and a history of hemolytic crisis correlated inversely with PHT. Systolic blood pressure and loud P2 are independent predictors of PHT in this study. Conclusion PHT had a prevalence of 16.3% in patients with SCA in this study. There is no significant effect of PHT on RV systolic function in patients with SCA.