Amadi Valentine N, Balogun Michael O, Akinola Norah O, Adebayo Rasaaq A, Akintomide Anthony O
Department of Internal Medicine, Federal Medical Centre, Asaba, Delta State.
Cardiac Care Unit, Department of Medicine.
Vasc Health Risk Manag. 2017 May 8;13:153-160. doi: 10.2147/VHRM.S92799. eCollection 2017.
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.
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.
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).
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; = 0.014). TRV and estimated MPAP had a significant inverse correlation with the 6MWD ( = -0.442; < 0.001 and = -0.571; < 0.001, respectively).
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.
镰状细胞贫血（SCA）是最常见的血红蛋白病，与高发病率和死亡率相关。据报道，肺动脉高压（PH）在这方面起着重要作用。关于尼日利亚SCA患者中PH的文献非常有限。
本研究的目的是确定SCA患者中多普勒衍生的PH的患病率，评估其对运动能力的影响，并确定估计肺动脉压力测量值的相关因素和预测因素。
共有92名SCA患者接受了超声心动图检查和6分钟自定步速步行运动。通过多普勒超声心动图发现三尖瓣反流速度（TRV）≥2.5 m/s来诊断PH。还评估了肺血流情况以估计平均肺动脉压（MPAP）。
在23.9%的成年SCA患者中检测到多普勒衍生的PH。患有PH的SCA成年患者的6分钟步行距离（6MWD）显著低于未患PH的患者（380.33±63.17米对474.28±76.74米；P = 0.014）。TRV和估计的MPAP与6MWD呈显著负相关（分别为r = -0.442；P < 0.001和r = -0.571；P < 0.001）。
多普勒检测出的PH在尼日利亚成年SCA患者中很常见，并且对运动能力有显著的负面影响。应鼓励对PH进行筛查，以优化管理，从而改善他们的生活质量和预期寿命。
