Cardiovascular Journal of Africa: Vol 27 No 1 (January/February 2016)

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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 27, No 1, January/February 2016 20 AFRICA
PR interval, was significantly higher among SCA children with
ECG abnormalities in this study. Studies have shown that elevated
triglyceride levels independently predicted the development of
coronary artery disease and myocardial infarction.23 Also, it was
reported recently that an elevated level of triglycerides, which is
already known to be linked with endothelial dysfunction, is an
independent predictor of pulmonary hypertesion in patients with
SCA.29 Raised triglyceride levels is an important cardiovascular
risk factor for atherogenesis, as other abnormalities of the
lipid profile are much more likely and are a readily available
complement to atheromatous plaque formation and progression.
Our study was limited by the small sample size, which
may have affected proper data interpretation and the overall
generalisability of the findings. Also, fasting samples for lipid
estimations were not taken. However, non-fasting lipid levels
have been significantly correlated with fasting triglyceride levels,
and there is new evidence to show that triglyceride levels
measured in the fasting or non-fasting state are important in
determining the prognosis of cardiovascular diseases.
Conclusion
This study showed that lipid and electrocardiographic
abnormalities were common among the children with SCA
attending the paediatric out-patient clinic of WGH, Ilesa, and
they were closely related to the cardiovascular risk of these
patients.
References
1. Adebayo RA, Balogun MO, Akinola NO, Akintomide NO. The
clinical, electrocardiographic and self-paced walking exercise features of
Nigerians with sickle cell anaemia at OAUTHC, Ile-Ife. Nig J Med 2002;
11: 170–176. PMID: 12955994.
2. Bode-Thomas F, Ogunkunle OO, Omotoso AB. The QT interval in
Nigerian children with sickle cell anaemia. Trop Cardiol 2003; 29(113):
9–12.
3. Odia OJ. Electrocardiographic observations in patients with sickle cell
diseases. Trop Cardiol 1990; 16: 135–138.
4. Araoye MA. Left ventricular hypertrophy by electrocardiography: A
code system applicable to Negroes. Nig Postgrad Med J 1996; 3: 92–97.
5. Zorca S, Freeman L, HildesheimM, Allen D, Remaley AT, Taylor JG, et
al. Lipid levels in sickle-cell disease associated with haemolytic severity,
vascular dysfunction and pulmonary hypertension. Br J Haematol 2010;
149: 436–445. doi: 10.1111/j.1365-2141.2010.08109.x.
6. Van der Jagt DJ, Shores J, Okorodudu A, Okolo SN, Glew RH.
Hypocholesterolemia in Nigerian children with sickle cell disease. J Trop
Pediatr 2002; 48: 156–161. PMID: 12164599.
7. Shores J, Peterson J, van der Jagt D, Gless RH. Reduced cholesterol
levels in African-American adults with sickle cell disease. J Natl Med
Assoc 2003; 95: 813–817. PMID: 14527048. PMC2594470.
8. Seixas MO, Rocha LC, Carvalho MB, et al . Levels of high-density
lipoprotein cholesterol (HDL-C) among children with steady-state sickle
cell disease. Lipids Health Dis 2010; 9: 91. doi:10.1186/1476-511X-9-91.
PMCID: PMC2940866.
9. Stuart MJ, Nagel RL. Sickle cell disease. Lancet 2004; 364: 1343–1360.
doi: 10.1016/S0140-6736(04)17192-4.
10. Ballas S.K, Lieff S, Benjamin L.J, Dampier C.D, Heeney M.M, Hoppe
C, et al. Definitions of the phenotypic manifestations of sickle cell
disease. Am J Hematol 2010; 85: 6–13. doi: 10.1002/ajh.21550.
11. Olusanya O, Okpere E, Ezimokhai M. The importance of social class
in voluntary fertility control in a developing country. West Afr J Med
1985; 4: 205–212.
12. Robinson TN, Dietz WH. Weight Gain: Overeating to Obesity. In:
Rudolph CD, Rudolph AM, eds. Rudolph’s Paediatrics, 21st edn. New
York: McGraw-Hill Medical, 2003: 476–481.
13. Swash M. The gastrointestinal system. In: Glynn M, Drake W, eds.
Hutchison’s Clinical Methods : An Integrated Approach to Clinical
Practice, 23rd edn. New York: Elsevier, 2012: 166–173.
14. Falkner B, Daniels SR. Summary of the fourth report on the diagnosis,
evaluation, and treatment of high blood pressure in children and adoles-
cents. AHA Hypertens 2004; 44: 387–388.
15. Frieldwald WT, Levy RI, Fredricson DS. Estimation of the concentration
of low density lipoprotein cholesterol in plasma without use of preprepar-
ative ultra centrifuge. Clin Chem 1972; 18: 499–502. PMID: 4337382.
16. Oguanobi NI, Ejim EC, Anisiuba BC, Onwubere BJC, Ike SO,
Ibegbulam OG, et al. Clinical and electrocardiographic evaluation
of sickle-sell anaemia patients with pulmonary hypertension. ISRN
Hematol 2012; Art ID 768718, 6 pages. doi: 10.5402/2012/768718.
17. Kolawole AJ, Omokhodion SI. Normal limits for pediatric electro-
cardiogram in Ilorin, Nigeria. Nig J Cardiol 2014; 11: 112–123. DOI:
10.4103/0189-7969.142103.
18. Sokolow M, Lyon TP. The ventricular complex in left ventricular hyper-
trophy as obtained by unipolar leads. Am Heart J 1949; 37: 161–186.
PMID: 18107386.
19. Kato GJ, Gladwin MT, Steinberg MH. Deconstructing sickle cell
disease: reappraisal of the role of hemolysis in the development of
clinical subphenotypes. Blood Rev 2007; 21: 37–47. PMID: 7084951
PMC2048670.
20. Uzsoy NK. Cardiovascular findings in patients with sickle cell anaemia.
Am J Cardiol 1964; 13: 320–328. PMID: 14128641.
21. Oguanobi NI, Onwubere BJC, Ike SO, Anisiuba BC, Ejim EC,
Ibegbulam OG. Electrocardiographic findings in adult Nigerians with
sickle cell anaemia. Afr Health Sci 2010; 10(3): 235–241. PMCID:
PMC3035954.
22. Bode-Thomas F, Ogunkunle OO, Omotoso ABO. Cardiac arrhythmias
in children with sickle cell anaemia. Nig J Paediatr 2003; 30(1): 13–17.
23. Voskaridou E, Christoulas D, Terpos E. Sickle cell disease and the heart:
review of the current literatures. Br J Hematol 2012; 157(6): 664–673.
doi: 10.1111/j.1365-2141.2012.09143.x
24. Adegoke OA, Adegoke SA, Okeniyi JAO, Smith OO. Serum cardiac
troponin T (cTnT) in Nigerian children with sickle cell anaemia: an
index of myocardial injury? Int J Med Medical Sci 2013; 3(2): 376–380.
25. Bode-Thomas F, Hyacinth HI, Ogunkunle O, Omotoso A.
Myocardial ischaemia in sickle cell anaemia: evaluation using a
new scoring system. Ann Trop Paediatr 2011; 31(1): 67–74. doi:
10.1179/1465328110Y.0000000006.
26. Liem RI, Young LT, Thompson AA. Prolonged QTc interval in children
and young adults with sickle cell disease at steady state. Pediatr Blood
Cancer 2009; 52(7): 842–846. doi: 10.1002/pbc.21973.
27. Berul CI. Congenital long-QT syndromes: who’s at risk for sudden
cardiac death? Circulation 2008; 117: 2178–2180. doi: 10.1161/
CIRCULATIONAHA.108.772053.
28. Kolo PM, Sanya EO, Olanrewaju TO, Fawibe AE, Soladoye A. Cardiac
autonomic dysfunction in sickle cell anaemia and its correlation with QT
parameters. Nig Med J 2013; 54(6): 382–385.
29. Akinlade KS, Adewale CO, Rahamon SK, Fasola FA, Olaniyi JA,
Atere AD. Defective lipid metabolism in sickle cell anaemia subjects in
vaso-occlusive crisis. Nig Med J 2014; 55: 428–431. doi: 10.4103/0300-
1652.140388.