title: Echocardiography-derived tricuspid regurgitant jet velocity is an important marker for the progression of sickle-cell disease.
abstract: BACKGROUND
  Although echocardiography-derived tricuspid regurgitant jet velocity (TRV) is associated with increased mortality in sickle-cell disease (SCD), it is unclear whether increased TRV is a marker of multiorgan disease due to systemic vasculopathy or related to increased pulmonary artery systolic pressure with episodes of multiple acute chest syndrome (ACS).
  
  
  METHODS
  Our study analyzed 148 consecutive patients with transthoracic echocardiography with TRV data, who came to our adult SCD Clinic at the Wake Forest Baptist Medical Center. For our analysis, we took TRV ≥ 2.5 m/s as elevated. Patients were followed on average for 9 years.
  
  
  RESULTS
  TRV ≥ 3 m/s was significantly associated with increased mortality (p < 0.001), thromboembolism (p < 0.001), hospitalization for ACS (p < 0.001), supraventricular arrhythmia (p = 0.028), right ventricular (RV) dilation, decreased hemoglobin and increased creatinine. Patients with a progressive increase in TRV during follow-up had increased mortality (36.7 vs. 8.6%, p = 0.007) and increased ACS (45 vs. 5.7%, p < 0.001). Death was independently associated with TRV ≥ 3 m/s (p = 0.023), ACS (p = 0.001) and increased RV basal diameter (p = 0.003).
  
  
  CONCLUSIONS
  TRV is an important global marker for the severity and progression of SCD, and carries a significant prognostic implication.
authors.forename: Bharathi
authors.initials: B
authors.lastname: Upadhya
authors.forename: Richard Brandon
authors.initials: RB
authors.lastname: Stacey
authors.forename: William
authors.initials: W
authors.lastname: Ntim
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Knovich
authors.forename: Min
authors.initials: M
authors.lastname: Pu
mesh_terms: D056586:Acute Chest Syndrome / Q000453:epidemiology / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000755:Anemia, Sickle Cell / Q000097:blood / Q000150:complications / Q000401:mortality / Q000503:physiopathology*; D002648:Child; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006461:Hemolysis; D006801:Humans; D017380:Hypertrophy, Right Ventricular / Q000000981:diagnostic imaging / Q000209:etiology; D019190:Iron Overload / Q000097:blood / Q000209:etiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D013318:Stroke Volume; D013923:Thromboembolism / Q000453:epidemiology / Q000209:etiology; D014262:Tricuspid Valve Insufficiency / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology; D014463:Ultrasonography; D055815:Young Adult