The cardiovascular complications are the major prognostic factor for Sickle cell disease (SCD).
Methods
This was a descriptive cross-sectional study in the cardiology department of the University Hospital of Brazzaville. 79 patients, included by drawing lots from hematology department file of University Hospital center of Brazzaville, were compared to 73 non-sickle cell subjects. Echocardiographic data were collected and laboratory parameters: hemoglobin.
Results
The 79 sickle cell patients were distributed in 48 women (60.8%) and 31 men (39.2%), mean age 27.0±9.9 years. The average hemoglobin was 7.8±0.9g/dl. We observed on echocardiography left ventricular dilatation in 12 patients (15.2%), right ventricular dilatation in three patients, left atrial dilatation in 34 patients (43.0%) and right atrial dilatation in 14 patients (17.7%). The ejection fraction of the left ventricle was on average 69.4±7.2%. Left ventricular hypertrophy was present in 68 patients (86.1%). We observed a normal mitral profile in 73 cases (92.4%). Pulmonary hypertension was found in 42 patients (53.2%). The comparison with non-sickle cell population showed a significant difference in favor of sickle cell on the left atrium (22.1 vs 14.1; p=0.000), the right atrium (16.9 vs 12.3; p=0.000), the left ventricle (55.0 vs 46.8; p=0.000), the right ventricle (21.2 vs 17.0; p=0.000), left ventricular mass (138.5 vs 80.0; p=0.000), cardiac output (7.4 vs 5.3, p=0.007) and the maximum flow velocity of tricuspid regurgitation (23.0 vs 19.6; p=0.000).
Conclusion
Doppler echocardiography is an essential technic in the assessment of sickle cell patients. It enables the early detection of certain heart complications, especially pulmonary hypertension, making the prognosis of this disease.
