GLOBAL LONGITUDINAL LEFT VENTRICULAR STRAIN AND ITS CORRELATES IN BLACK NIGERIAN SICKLE CELL DISEASE (SCD) PATIENTS: PROTOCOL FOR A PILOT STUDY.

Abstract

Background: Sickle cell cardiomyopathy is becoming a neglected tropical cardiovascular disease, yet the most common cause of death in HbSS patients. Myocardial strain using speckle tracking has recently been validated as a tool for the detection of subclinical left ventricular systolic dysfunction. Its utility in sickle cell disease in Nigeria is unknown.

Objectives: The study aims to evaluate global longitudinal left ventricular (GL LV) strain pattern in black SCD patients in steady state, and correlate that with clinico-laboratory and electrocardiographic (ECG) measurements. Furthermore, we will evaluate the timeline for the earliest detectable cardiac changes in SCD detectable by ECG or speckle tracking.

Method: 60 sickle cell patients between ages 5 and 40 years will be matched with 60 controls. Baseline clinic-laboratory data will be collected. All participants will have electrocardiography and speckle-tracking echocardiography of the left ventricle. The primary outcome is the global LV longitudinal strain in HBSS and matched control. Secondary outcomes are the clinico-laboratory and electrocardiographic correlates of LV strain in black HBSS patients as well as tracking the earliest detectable cardiovascular change in the life spectrum from childhood to adulthood. Regression analysis and other statistical models will be used.

Conclusion: The simplicity of the study design is crafted to spark interest in life-threatening cardiovascular complications of sickle cell disease beyond pulmonary hypertension.