Right Ventricular Function Assessment in Sickle Cell Anaemia Patients Using Echocardiography

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Right ventricular dysfunction has been linked to poor prognosis in people with sickle cell anaemia (SCA). There is however a paucity of studies on right ventricular function in SCA. The objectives were to determine right ventricular function in subjects with SCA using echocardiography and compare results with controls. The study design was descriptive and cross sectional. Echocardiography was done to assess both systolic and diastolic function of subjects with SCA and controls. Eighty-six subjects with SCA and eighty-nine controls with haemoglobin A were recruited. The sickle cell group had a mean age of 27.6±7.6 while controls were 28.9±8.9. Right ventricular fractional area change (RVFAC) was not significantly different between both groups. However, tricuspid annular plane systolic excursion (TAPSE) and peak tricuspid annular systolic velocity (S) were increased in the sickle cell group as compared with controls. The sickle cell group also had more diastolic dysfunction (Transtricuspid early (E)/late (A) diastolic filling ratio) than controls, though not attaining statistical significance. The Transtricuspid E/Eʹ was significantly increased in subjects as compared to controls. Binary logistic regression revealed low body mass index (BMI) as the predictor of diastolic dysfunction among the sickle cell subjects and controls studied. Systolic function is largely preserved in sickle cell subjects. TAPSE and Sʹ values are actually increased in the subjects as compared to controls, suggesting that the right ventricle becomes hyperdynamic to compensate for the chronic anaemia. Diastolic dysfunction is present in sickle cell subjects with the important predictor being underweight BMI.

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