title: Pulmonary hypertension in sickle cell disease: diagnosis and management.
abstract: The increased survival of patients with sickle cell disease (SCD) into adulthood is associated with an increased incidence of multiorgan dysfunction and a progressive systemic and pulmonary vasculopathy. The high prevalence of an elevated tricuspid regurgitant jet velocity and its association with an increased risk of death in adult patients is well established. However, there has been controversy regarding the prevalence of pulmonary hypertension (PH) and its association with mortality in SCD. Multiple recently published reports demonstrate that PH as diagnosed by right heart catheterization is common in adult SCD patients, with a prevalence of 6%-11%. Furthermore, PH is associated with an increased risk of death in SCD patients. In this chapter, we provide evidence for the high prevalence of PH in SCD and its association with mortality and make recommendations for its evaluation and management. Finally, we provide the rationale for screening for this life-threatening complication in adult patients with SCD.
authors.affiliation: Division of Hematology/Oncology, University of North Carolina, Chapel Hill, NC; and.
authors.forename: Kenneth I
authors.initials: KI
authors.lastname: Ataga
authors.affiliation: The Pulmonary Center, Boston University School of Medicine, Boston, MA.
authors.forename: Elizabeth S
authors.initials: ES
authors.lastname: Klings
mesh_terms: D000755:Anemia, Sickle Cell / Q000150:complications* / Q000401:mortality; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D008403:Mass Screening; D015995:Prevalence; D014262:Tricuspid Valve Insufficiency / Q000150:complications