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Adeola Olubunmi Ajibare,1 Olatunde Peter Olabode,2 Emmanuel Yemi Fagbemiro,3 Olawale Mathias Akinlade,4 Adeseye Abiodun Akintunde,4 Oluwaseun Oyetope Akinpelu,5 Lawrence Aderemi Olatunji,6 Ayodele Olufemi Soladoye,6 Oladimeji George Opadijo4 1Department of Medicine, Lagos State University College of Medicine Ikeja, Lagos, Nigeria; 2Cardiology Unit, BT Diagnostics, LASUTH, Ikeja, Lagos, Nigeria; 3Department of Medicine, College of Medicine, Nile University, Abuja, Nigeria; 4Cardiology Unit, Department of Internal Medicine, LAUTECH Teaching Hospital, Ogbomoso, Nigeria; 5Department of Hematology, LAUTECH Teaching Hospital, Ogbomoso, Nigeria; 6Department of Physiology, University of Ilorin, Ilorin, NigeriaCorrespondence: Adeola Olubunmi Ajibare Tel +234 8033251010Email adeola.ajibare@lasucom.edu.ngBackground: Many specific and non-specific electrocardiographic abnormalities including ventricular arrhythmias have been reported in subjects with sickle cell anemia (SCA). In SCA patients, cardiac electrical abnormalities may be the leading cause of increased risk of arrhythmias. The corrected QT (QTc) interval, peak to the end of the T wave (Tp-e) interval and associated Tp-e/QTc ratio are promising measures of altered ventricular repolarization and increased arrhythmogenesis risk.Aim: This study assessed ventricular repolarization abnormalities in subjects with SCA using the QTc interval, Tp-e interval and Tp-e/QTc ratio, and also evaluated the gender differences in these parameters, as well as their determinants.Methods: Sixty subjects with SCA and 60 healthy control subjects, matched for age and gender, were studied. All participants underwent physical examination, hematological and biochemical evaluation, and 12-lead electrocardiography (ECG) recording. QT and Tp-e intervals were measured from the ECG, and the QTc interval was calculated using Bazett’s formula. Tp-e/QT and Tp-e/QTc ratios were also derived.Results: QT and QTc intervals were prolonged in subjects with SCA. Tp-e interval, Tp-e/QT ratio and Tp-e/QTc ratio were prolonged in male SCA subjects, with a paradoxical shortening in female SCA subjects. Plasminogen activator inhibitor-1 (PAI-1) was an independent determinant of QTc, while body mass index (BMI) was an independent determinant of both Tp-e interval and Tp-e/QTc ratio.Conclusion: Our results suggest an elevated risk for ventricular arrhythmogenesis in male SCA subjects. Furthermore, increased BMI and PAI-1 level are possible markers of ventricular repolarization abnormalities in SCA subjects.Keywords: arrhythmias, electrocardiography, sickle cell anemia, ventricular repolarization, QTc interval, Tp-e interval |
