title: Transthoracic echocardiography and 6-minute walk test in Kuwaiti sickle cell disease patients.
abstract: OBJECTIVE
  The aim of this study was to investigate cardiac abnormalities in Kuwaiti sickle cell disease (SCD) patients using markers such as tricuspid regurgitant jet velocity (TRJV), pulmonary artery systolic pressure (PASP), and the 6-minute walk (6MW) test and correlate these findings with clinical, hematological, and biochemical parameters.
  
  
  METHODS
  Seventy-three patients with SCD and 70 matched controls were studied. The cardiac status was investigated using transthoracic echocardiography in 57 patients; the 6MW test was carried out in patients and controls. Complete blood counts and hemolytic parameters were assessed.
  
  
  RESULTS
  Reticulocytes, bilirubin, and lactate dehydrogenase were significantly higher (p < 0.0001) in patients, while hemoglobin (Hb) and haptoglobin were lower (p < 0.0001) than in controls. The mean fetal Hb among patients was 15.85 ± 8.7%. Of the 57 patients, 14 (24.5%) and 15 (26%) had mild tricuspid and mitral regurgitation, respectively. The mean ejection fraction, TRJV, and PASP were 63.9 ± 6.3%, 1.7 ± 0.5 m/s, and 23.0 ± 7.3 mm Hg, respectively. Three (5.2%) patients had mildly raised TRJV (2.6-2.97 m/s, normal range <2.5 m/s) while 8 (14%) had high PASP (mean 35.3 ± 5.1 mm Hg, normal range <30 mm Hg). Hb, hematocrit, and reticulocytes were different (p = 0.010, p = 0.006, and p = 0.011, respectively) between patients with normal and high PASP. All 3 patients who had a high TRJV had a high PASP, and 2 of these patients died during follow-up. The systolic and diastolic blood pressure, oxygen saturation before and after the 6MW test, and distance walked were lower (p = 0.006, p = 0.000, p = 0.002, p = 0.000, and p = 0.000, respectively) in patients compared to controls.
  
  
  CONCLUSIONS
  Raised PASP was common in Kuwaiti SCD patients while raised TRJV was not.
authors.affiliation: Department of Pathology, Faculty of Medicine, Kuwait University, Safat, Kuwait.
authors.forename: Rajaa
authors.initials: R
authors.lastname: Marouf
authors.forename: Nasser
authors.initials: N
authors.lastname: Behbehani
authors.forename: Mohammed
authors.initials: M
authors.lastname: Zubaid
authors.forename: Hanan
authors.initials: H
authors.lastname: Al Wazzan
authors.forename: Hadeel
authors.initials: H
authors.lastname: El Muzaini
authors.forename: Rasha
authors.initials: R
authors.lastname: Abdulla
authors.forename: Olusegun A
authors.initials: OA
authors.lastname: Mojiminiyi
authors.forename: Adekunle D
authors.initials: AD
authors.lastname: Adekile
mesh_terms: D000328:Adult; D000368:Aged; D000755:Anemia, Sickle Cell / Q000453:epidemiology / Q000503:physiopathology*; D015415:Biomarkers; D001794:Blood Pressure; D004452:Echocardiography; D005080:Exercise Test; D005260:Female; D006334:Heart Function Tests; D006403:Hematologic Tests; D006801:Humans; D007730:Kuwait; D008297:Male; D008875:Middle Aged; D014262:Tricuspid Valve Insufficiency / Q000453:epidemiology
chemical_list: D015415:Biomarkers
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