Pulmonary hypertension in sickle-cell disease: comorbidities and echocardiographic findings.
BACKGROUND
Our aim is to determine comorbidities associated with pulmonary hypertension (PHT) in clinically stable sickle-cell disease (SCD) patients and to evaluate left ventricular (LV) and right ventricular (RV) function in those patients.


METHODS
Echocardiography was performed in 87 SCD patients that were divided into group I (without PHT) and group II (with PHT). Both groups were compared with healthy controls.


RESULTS
A history of retinopathy and leg ulcer was more frequent in group II than group I (p < 0.01). Haemoglobin levels were lower (p < 0.05), whereas blood urea nitrogen, lactate dehydrogenase and total bilirubin levels were higher in group II (p < 0.01). Although group II patients had larger LV end-diastolic, LV end-systolic and RV diastolic diameters compared with group I patients and controls (p < 0.05), LV ejection fraction was similar in the three groups. The mitral peak early diastolic inflow velocity to peak late diastolic inflow velocity (E/A) ratio was similar in group I, group II and the control group. The tricuspid E/A ratio was lower in group II than group I and controls (p < 0.05).


CONCLUSIONS
End organ damage occurs more often and haemolysis is severer in SCD patients with PHT than SCD patients without PHT. Although LV systolic and diastolic function is well preserved, RV diastolic function is disturbed in those patients with PHT.
Akgül
Ferit
F
Department of Cardiology, Faculty of Medicine, Mustafa Kemal University, Antakya, Turkey. feritakgul1@yahoo.ca
Yalçin
Fatih
F
Seyfeli
Ergün
E
Uçar
Edip
E
Karazincir
Sinem
S
Balci
Ali
A
Gali
Edip
E
D000293:Adolescent; D017677:Age Distribution; D000755:Anemia, Sickle Cell / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D016022:Case-Control Studies; D002648:Child; D015331:Cohort Studies; D015897:Comorbidity; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D015994:Incidence; D008297:Male; D011336:Probability; D011379:Prognosis; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D013318:Stroke Volume; D015996:Survival Rate; D018615:Ultrasonography, Doppler, Color; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000453:epidemiology