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Abstract：
Introduction Sickle cell anemia (SCA), a severe hematological disorder, is characterized by the presence of sickle-shaped erythrocytes that obstruct capillaries and restrict blood flow. This pathophysiology not only promotes systemic complications but may also influence cardiac function. Cardiac complications are a leading cause of mortality in SCA patients, yet the specific electrocardiographic (ECG) changes associated with disease severity are not thoroughly understood. This cross-sectional study aimed to explore ECG abnormalities in adults with SCA and correlate these findings with disease severity. Methods An observational cross-sectional study was conducted over 18 months, from January 2022 to June 2023, among 140 SCA patients at the Sickle Cell OPD of All India Institute of Medical Sciences, Raipur, Raipur, India. Steady-state SCA (HbS >50%) patients screened by high-performance liquid chromatography were enrolled. A history, physical examination, complete blood count, and ECG were done for all cases. The disease severity score was calculated using the Adegoke and Kuti severity scores, and their association with various ECG changes was studied. The chi-square test (Fisher\'s exact test, wherever applicable) was used for comparing the proportion. The correlation was done using the Pearson correlation coefficient or Spearman\'s rho. Results Out of 140 patients, the mean age of the study participants was 26 ± 6 years. More than half of the cases (80; 57%) fall under the 18-27 age group, with a male-to-female ratio of 4:3. A total of 99 (70.7%) of the participants had mild disease, and 41 (29.3%) had moderate disease. The QT interval was significantly higher among patients with mild disease compared to those with moderate disease (p-value: <0.01). QTc dispersion and prolonged QTc interval were significantly higher among patients with moderate disease compared to mild disease (p-value <0.01, 0.04, respectively). Sinus tachycardia and right ventricular hypertrophy with p-pulmonale were significantly higher in moderate severity (p < 0.01). A significant positive correlation was observed between QTc dispersion, P-wave dispersion, and severity (r: 0.19, 0.17; p-value: 0.02, 0.04, respectively). Conclusion As the disease severity progressed, the ECG changes studied had a higher distribution and significance. ECG is a readily and widely accessible investigation that can be used to screen all SCA patients for early recognition of various underlying cardiac complications.
摘要：
简介镰状细胞性贫血（SCA），严重的血液病,其特征是存在镰刀形红细胞，阻塞毛细血管并限制血液流动。这种病理生理学不仅会促进全身并发症，还会影响心脏功能。心脏并发症是SCA患者死亡的主要原因，然而,与疾病严重程度相关的具体心电图(ECG)变化尚不完全清楚.这项横断面研究旨在探索患有SCA的成年人的ECG异常，并将这些发现与疾病严重程度相关联。方法进行为期18个月的观察性横断面研究，从2022年1月到2023年6月，在全印度医学科学研究所镰状细胞OPD的140名SCA患者中，雷普尔,雷普尔,印度。纳入经高效液相色谱法筛选的稳态SCA(HbS>50%)患者。一段历史，体检,全血细胞计数,对所有病例进行心电图检查。使用Adegoke和Kuti严重程度评分计算疾病严重程度评分，并研究了它们与各种ECG变化的关联。卡方检验(Fisher精确检验，在适用的情况下)用于比较比例。使用Pearson相关系数或Spearmanrho进行相关性。结果140例患者中,研究参与者的平均年龄为26±6岁.超过一半的病例（80;57％）属于18-27岁年龄段，男女比例为4:3。共有99名(70.7%)参与者患有轻度疾病,41例(29.3%)患有中度疾病。轻度疾病患者的QT间期明显高于中度疾病患者（p值：<0.01）。与轻度疾病相比，中度疾病患者的QTc离散度和QTc间期延长明显更高（p值分别<0.01、0.04）。窦性心动过速和右心室肥厚伴肺心病中度患者明显增高(p<0.01)。QTc离散度之间呈显著正相关，P波色散,和严重程度（r：0.19，0.17；p值：0.02，0.04，分别）。结论随着病情的加重,所研究的ECG变化具有较高的分布和意义.ECG是一种容易且广泛获得的研究，可用于筛查所有SCA患者，以早期识别各种潜在的心脏并发症。
