A new study has determined that concentric left ventricle hypertrophy (LVH) correlates strongly with pulmonary hypertension (PHT) and a poor prognosis in patients with sickle cell anemia (SCA), a form of sickle cell disease (SCD).
The study, published in the American Journal of Cardiology, also found relative systemic hypertension, history of chest pain, and respiratory rate to be correlated with PHT in patients with SCD.
“Left ventricular (LV) diastolic dysfunction, chronic mitral regurgitation, sickle cell lung disease, and pulmonary thromboembolism are potential mechanisms for PHT,” the authors wrote. “Abnormal LV geometric patterns have been found in SCA, especially eccentric LV hypertrophy. However, the correlation of PHT with LV geometric patterns in the SCA populace has not been well evaluated yet.”
The research team conducted a cross-sectional study on 111 participants aged 6 years and older diagnosed with SCD at a single center in Nigeria, 9 of whom had PHT. Demographic data, packed cell volume, New York Heart Association functional class, transfusions, LV characteristics, chest pain, and spirometry data were collected.
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The results revealed that concentric LVH was strongly associated with PHT, and no patient with PHT had eccentric LVH or concentric LV remodeling. LV mass and systemic hypertension were also higher in patients with PHT, and chest pain and avascular necrosis of the head of the femur were more common in those with PHT. Finally, age, body mass index, and a history of stroke were associated with a higher likelihood of PHT.
The authors noted that electrocardiographic data did not distinguish individuals with PHT from those without it, reinforcing the fact that electrocardiography is somewhat insensitive in detecting LVH.
Given that PHT has poor prognostic significance and is a major cause of morbidity in SCA, the authors recommend early treatment of these patients to improve outcomes.
Reference
Oni OO, Odeyemi AO, Olasinde YT, et al. Pulmonary hypertension and left ventricular geometric types in sickle cell anemia. Am J Cardiol. Published online September 15, 2023. doi:10.1016/j.amcard.2023.06.100
