Objective: To study the electrical and echocardiographic aspects in patients with major sickle cell syndrome. Methods: This was a prospective descriptive cross-sectional study carried out at the National Reference Center for Sickle Cell Disease and the cardiology department of the National Hospital of Niamey over a period of 6 months (from September 2021 to February 2022). Results: We included 100 patients, including 53 women and 47 men, with a sex ratio of 0.88. The average age was 32.6 ± 12 years, with extremes ranging from 16 to 65 years. The SS phenotype represented 87%, the SC phenotype 11% and only 2% of S beta-thalassemia. The mean baseline hemoglobin level was 8.89 ± 1.6 g/dL. Electrically, we found QT elongation, left ventricular hypertrophy, sinus tachycardia, negative T waves, first-degree atrioventricular block, right ventricular hypertrophy and left atrial hypertrophy in respectively 28%, 15%, 14%, 11%, 4% and 3% of cases. Echocardiographic abnormalities were dominated by valve involvement in 64% of cases with 53% valve leakage, 4% mitral insufficiency, 5% aortic insufficiency, 2% moderate to severe tricuspid insufficiency; followed by dilation of the left atrium and left ventricle in 30% and 13% of cases respectively. Dilation of the right ventricle and right atrium was present in 3% and 4% of cases, respectively. 4 cases of pulmonary arterial hypertension and 4 cases of ventricular communication were observed. We also noted 1 case of systolic dysfunction, 1 case of hypokinetic dilated cardiomyopathy. The homozygous SS form was found to be the most severe. Conclusion: Sickle cell disease is a severe disease whose prognosis is worsened by cardiac involvement.
References
[1]
Renaudier, P. (2014) Physiopathologie de la drépanocytose. Transfusion Clinique et Biologique, 21, 178-181. https://doi.org/10.1016/j.tracli.2014.08.139
[2]
Essono, E.M. and Nkoa, T. (2004) Diagnostic et anomalies biologiques chez un drépanocytaire. Medicine Clinics in Mother and Child Health, 1, 12-20.
[3]
Idriss, L. (2021) Journée Mondiale de l’enfance: Combattre la drépanocytose chez les enfants. https://www.journalducameroun.com
[4]
Grosse, S.D., Odame, I., Atrash, H.K., Amendah, D.D., Piel, F.B. and Williams, T.N. (2011) Sickle Cell Disease in Africa. American Journal of Preventive Medicine, 41, S398-S405. https://doi.org/10.1016/j.amepre.2011.09.013
[5]
Lena-Russo, D., Nord, M.L. and Girot, R. (1992) Epidemiology of Genetic Hemoglobin Diseases in Metropolitan France. La Revue du Praticien, 45, 1867-1872.
[6]
Sambo, G. (2011) Drépanocytose en Afrique: 500.000 naissances annuelles Organisation mondiale de la santé (OMS/Afro). Brazzaville.
[7]
Ministère de la santé publique du Niger (2009) Guide de prise en charge de la drépanocytose au Niger.
[8]
Hau, I. and Coic, L. (2008) L’enfant drépanocytaire aux urgences. Médecinethérapeutique/Pédiatrie, 11, 35-42.
[9]
Thuilliez, V., Ditsambou, V., Mba, J.R., Mba Meyo, S. and Kitengue, J. (1996) Aspects actuels de la drépanocytose chez l’enfant au Gabon. Archives de Pédiatrie, 3, 668-674. https://doi.org/10.1016/0929-693x(96)87087-4
[10]
Bertrand, E. (2005) Is the Sickle-Cell Trait a Risk Factor? MedecineTropicale, 65, 379-381.
[11]
Kane, A., Mbengue-Dièye, A., Dièye, O., Sylla, A., Sall, G., Diouf, S.M., et al. (2001) Aspects échocardiographiques au cours de la drépanocytose en milieu pédiatrique. Archives de Pédiatrie, 8, 707-712. https://doi.org/10.1016/s0929-693x(00)00302-x
[12]
Batra, A.S., Acherman, R.J., Wong, W., Wood, J.C., Chan, L.S., Ramicone, E., et al. (2002) Cardiac Abnormalities in Children with Sickle Cell Anemia. American Journal of Hematology, 70, 306-312. https://doi.org/10.1002/ajh.10154
[13]
Akinlade, O.M., Akintunde, A.A., Olabode, O.P., Olatunji, L.A., Akinpelu, O.O., Soladoye, A.O., et al. (2019) Evaluation of Tp-e Interval and Tp-e/QTc Ratio among Patients with Steady State Sickle Cell Disease. World Journal of Cardiovascular Diseases, 9, 425-436. https://doi.org/10.4236/wjcd.2019.96038
[14]
Lee, M.T., Rosenzweig, E.B. and Cairo, M.S. (2007) Pulmonary Hypertension in Sickle Cell Disease. Clinical Advances in Hematology & Oncology, 5, 645-653.
[15]
Gladwin, M.T., Sachdev, V., Jison, M.L., Shizukuda, Y., Plehn, J.F., Minter, K., et al. (2004) Pulmonary Hypertension as a Risk Factor for Death in Patients with Sickle Cell Disease. New England Journal of Medicine, 350, 886-895. https://doi.org/10.1056/nejmoa035477
[16]
Bouwe, M. (2022) Trait drépanocytaire et paludisme: Étude prospective comparative et descriptive chez les sujets AA et AS. Ph.D. Thesis, Niamey Université Abdou Moumouni de Niamey.
[17]
Ndongo, A.S., Tchoungui, R.F., Dieudonné, D., Hamadou, B., Kuate, M.L., Jingi, M.A., et al. (2018) Anomalies cardiaques chez les patients drépanocytaires adultes au Cameroun. Health Sciences and Diseases, 19, 45-48.
[18]
Koko, J., Mengue, C., Mouba, J.F., Gahouma, D., Minko, M. and Onewin, A.G. (2015) Complications cardiaques de la drépanocytose Service de Pédiatrie Générale, Hôpital Pédiatrique d’Owendo Libreville (Gabon). 3ème Congrès SAFHEMA.
[19]
Ondze-Kafata, L.I., Sanouiller, A., Hedreville, M., Hedreville, S. and Larifla, L. (2014) Aspects écho-cardiographiques au cours de la drépanocytose en Guadeloupe. Pan African Medical Journal, 18, Article 45. https://doi.org/10.11604/pamj.2014.18.45.3820
[20]
Leugueun, P.G. (2012) Evaluation de la rigidité artérielle par la mesure de la vitesse de l’onde de pouls chez les sujets atteints de syndromes drépanocytaires majeurs: Étude comparative cas/témoins. Ph.D Thesis, Université Cheick Anta Diop de Dakar.
[21]
Omar, R. (2019) Les aspects épidémiologiques et thérapeutiques des SDM (à propos de 735 cas colligés au CNRD). Ph.D Thesis, Université Abdou Moumouni de Niamey.
[22]
Ramatoulaye, H. (2020) Aspects épidémiologiques, diagnostiques et thérapeutiques des drépanocytaires SS suivis au CNRD de Niamey. Ph.D Thesis, Université Abdou Moumouni de Niamey.
[23]
Abdoul, A.H. (2020) La drépanocytose chez les enfants de moins de 5 ans: Aspects épidémiologique, clinique et thérapeutique au CNRD à propos de 380 cas. Ph.D Thesis, Université Abdou Moumouni de Niamey.
[24]
Tolo-Diebkilé, A., Koffi, K.G., Nanho, D.C., Sawadogo, D., Kouakou, B., Siransy-Bogui, L., et al. (2010) Drépanocytose homozygote chez l’adulte ivoirien de plus de 21 ans. Cahiers de Santé, 20, 63-67. https://doi.org/10.1684/san.2010.0184
[25]
Malam-Abdou, B., Brah, S., Salissou, L., Daou, M., Andia, A., Mahamadou, S., et al. (2015) Complications des syndromes drépanocytaires majeurs à l’Hôpital National de Niamey (Niger). Journal de la Recherche Scientifique de l’Université de Lomé, 17, 289-296.
[26]
Gnago Nina, P. (2008) La drépanocytose dans un service de Médecine interne. Etude de 33 cas chez l’adulte. Ph.D Thesis, Université Mohammed V-Souissi.
[27]
Ellenga-Mbolla, B.F., Okoko, A.R., Ekouya-Bowassa, G., Kocko, I., Oko, A., Moyen, E., et al. (2013) Anomalies électrocardiographiques de l’enfant drépanocytaire homozygote à Brazzaville (Congo). Cardiologie Tropicale, 137, 18-22.
[28]
Honga, V. (2006) Manifestations cardio-vasculaires de la drépanocytose chez l’enfant de 0 à 18 ans. Ph.D Thesis, Université de Bamako.
[29]
Caldas, M.C., Meira, Z.A. and Barbosa, M.M. (2008) Evaluation of 107 Patients with Sickle Cell Anemia through Tissue Doppler and Myocardial Performance Index. Journal of the American Society of Echocardiography, 21, 1163-1167. https://doi.org/10.1016/j.echo.2007.06.001
[30]
Raman, S.V., Simonetti, O.P., Cataland, S.R. and Kraut, H.E. (2006) Myocardial Ischemia and Right Ventricular Dysfunction in Adult Patients with Sickle Cell Disease. Haematologica, 91, 1329-1335.