Cardiac autonomic dysfunction in sickle cell anaemia and its correlation with QT parameters

Kolo, P.M.; Sanya, Emmanuel; Olanrewaju, Timothy Olusegun; Fawibe, Ademola Emmanuel; Soladoye, Ayodele O.

doi:10.4103/0300-1652.126288

Cited by 11 publications

(12 citation statements)

References 22 publications

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“…Prolonged and shortened QT C on ECG are both known risk factors for sudden cardiac death. 27 , 28 Although, the exact mechanism of prolonged QT C interval in sudden cardiac deaths in individuals with SCA is largely unknown, it is speculated that chronic anaemia and associated sub-acute cardiac ischaemia may be associated with ventricular repolarisation defects, which ultimately prolong QT C intervals. 28 …”

Section: Discussionmentioning

confidence: 99%

Electrocardiographic abnormalities and dyslipidaemic syndrome in children with sickle cell anaemia

Adegoke

Okeniyi

Akintunde

2016

CVJA

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SummaryBackgroundLipid and electrocardiographic (ECG) abnormalities have been reported in adults with sickle cell anaemia (SCA) and may reflect underlying structural and/ or functional damage. However, the relationship between ECG and lipid abnormalities among children with sickle cell disease is not fully understood.ObjectivesTo compare the steady-state lipid and ECG abnormalities in children with SCA to the controls and examine the hypothesis that lipid abnormalities are closely related to electrocardiographic abnormalities, and therefore are a reflection of cardiac damage among these children.Methods:Clinical, laboratory and ECG profiles of 62 children with SCA and 40 age- and gender-matched haemoglobin AA controls were compared. The influence of clinical characteristics, lipids profiles, markers of haemolysis, and renal and hepatic dysfunction on ECG pattern in children with SCA was then determined.ResultsThe patients had lower average diastolic and mean arterial blood pressure, total cholesterol and low-density lipoprotein cholesterol (LDL-C) levels than the controls, (p = 0.001, 0.002, 0.000 and 0.000, respectively). The mean triglyceride level was significantly higher (p < 0.001), while high-density lipoprotein cholesterol (HDL-C) levels were comparable (p = 0.858). The cases were about six times more likely to have left ventricular hypertrophy than the controls (OR = 6.4, 95% CI = 2.7–15.6, p = 0.000). Haematocrit level had a negative correlation with QTC (r = –0.3, p = 0.016) and QT intervals (r = – 0.3, p = 0.044). Triglyceride levels had a positive correlation with the PR interval (r = 0.3, p = 0.012), while serum alanine transferase (ALT) concentrations had an inverse correlation with PR interval (r = –0.3, p = 0.015). There was no statistical difference in the sociodemographic and clinical characteristics of the SCA children with or without ECG abnormalities. However, the mean triglyceride and serum ALT levels in those with ECG abnormalities were significantly higher than those without (p = 0.007 and 0.045, respectively).ConclusionLipid and ECG abnormalities are common in children with SCA. Elevated triglyceride and serum ALT levels are possible biochemical markers of ECG abnormalities in these patients.

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Section: Discussionmentioning

confidence: 99%

Electrocardiographic abnormalities and dyslipidaemic syndrome in children with sickle cell anaemia

Adegoke

Okeniyi

Akintunde

2016

CVJA

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“…Autonomic dysfunction and QT interval duration were correlated in patients with sickle cell anemia, suggesting significant clinical implications. The presence of hypoxia due to chronic anemia and cardiac autonomic neuropathy, with unopposed sympathetic activation and abnormalities of ventricular repolarization, predisposes to ventricular electrical instability and increased arrhythmia risk [ 100 ]. Several foci of old and new degeneration in the sinus and atrioventricular node and His bundle, fibrosis, and fibromuscular dysplasia affecting small coronary arteries were revealed by postmortem studies in patients with sickle cell anemia, responsible for electrical instability [ 102 ].…”

Section: Cardiovascular Consequences Of Hereditary Forms Of Anemiamentioning

confidence: 99%

Mechanisms Linking Red Blood Cell Disorders and Cardiovascular Diseases

Mozoş

2015

BioMed Research International

130

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The present paper aims to review the main pathophysiological links between red blood cell disorders and cardiovascular diseases, provides a brief description of the latest studies in this area, and considers implications for clinical practice and therapy. Anemia is associated with a special risk in proatherosclerotic conditions and heart disease and became a new therapeutic target. Guidelines must be updated for the management of patients with red blood cell disorders and cardiovascular diseases, and targets for hemoglobin level should be established. Risk scores in several cardiovascular diseases should include red blood cell count and RDW. Complete blood count and hemorheological parameters represent useful, inexpensive, widely available tools for the management and prognosis of patients with coronary heart disease, heart failure, hypertension, arrhythmias, and stroke. Hypoxia and iron accumulation cause the most important cardiovascular effects of sickle cell disease and thalassemia. Patients with congenital chronic hemolytic anemia undergoing splenectomy should be monitored, considering thromboembolic and cardiovascular risk.

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“…Kolo observed that Mean corrected QT (QTc) in sickle cell patients was significantly higher than the mean of controls. Similarly, mean QT dispersion (QTcd) was higher in the former than in the latter; the study showed that cardiac autonomic neuropathy is a risk factor for abnormalities of QT parameters in SCA and both may be harbinger for cardiac death [9].…”

Section: Introductionmentioning

confidence: 82%

“…SCD in its homozygous form has been linked with higher risk of ventricular arrhythmias and sudden death [9]. This study evaluates some of the risk factors…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Tp-e Interval and Tp-e/QTc Ratio among Patients with Steady State Sickle Cell Disease

Akinlade¹,

Akintunde²,

Olabode³

et al. 2019

WJCD

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Sickle cell disease (SCD) has been regarded as an inflammatory and procoagulatory disease with profound cardiovascular abnormalities including propensity for ventricular arrhythmogenesis. Tp-e and Tpe/QTc ratio however has been proposed as better indicators of arrythmogenesis and has been shown to be prolonged in many inflammatory conditions and correlate with levels of inflammatory markers. However, correlation between Tpe/QTc ratio and the level of highly sensitive C-reactive protein (hs-CRP) and plasminogen activator inhibitor (PAI) have not been reported in SCD. This study aims at evaluating Tp-e Interval and Tp-e/QTc ratio among steady state Sickle cell disease patients in relationship to the degree of anaemia, inflammatory and profibrotic markers. Methodology: A cross-sectional hospital-based study comprises 30 sickle cell anaemia patients in steady state with an equal number of controls having genotype HbAA and HbAS respectively. Clinical, laboratory and ECG parameters were obtained. Results: A total of 90 participants are with mean age 24.2 ± 5.6. The study showed that sickle cell disease patient had significantly lower level of PCV and higher level of PAI, platelet and total white cell count (p value < 0.05). C-reactive protein was also higher in them. 76.7% of HbSS patients had abnormal ECG. QTc and Tp-e were also prolonged in sickle cell disease patients compared with controls. An association was found between the level of PCV, PAI and prolonged Tp-e and QTc. Conclusion: Sickle cell disease patients have higher levels of inflammatory markers and abnormal ECG patterns are common in them. Moreover, the levels of these inflammatory markers correlate with Tp-e parameters.

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Cardiac autonomic dysfunction in sickle cell anaemia and its correlation with QT parameters

Cited by 11 publications

References 22 publications

Electrocardiographic abnormalities and dyslipidaemic syndrome in children with sickle cell anaemia

Electrocardiographic abnormalities and dyslipidaemic syndrome in children with sickle cell anaemia

Mechanisms Linking Red Blood Cell Disorders and Cardiovascular Diseases

Evaluation of Tp-e Interval and Tp-e/QTc Ratio among Patients with Steady State Sickle Cell Disease

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