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Abstract: Poster Presentations |

ASSESSMENT OF PULMONARY HYPERTENSION IN PATIENTS WITH SICKLE CELL DISEASE WITH TRICUSPID REGURGITANT JET VELOCITY OF GREATER THAN OR EQUAL TO 2.5 M/SECOND ON A ROUTINE ECHOCARDIOGRAM FREE TO VIEW

Mohammad Al-Ali, MD*; Tung Tran, MD; Pat Franklin, RN; Johnson Haynes, MD; Majid M. Mughal, MD
Author and Funding Information

University of South Alabama, Mobile, AL


Chest


Chest. 2009;136(4_MeetingAbstracts):61S. doi:10.1378/chest.136.4_MeetingAbstracts.61S-a
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Abstract

PURPOSE:  The aim of the present study is to provide hemodynamic and cardiopulmonary functions of sickle cell disease patients at a university hospital.

METHODS:  Patients with Sickle Cell Disease and tricuspid regurgitant jet velocity (TRJV) of ≥ 2.5 m/sec on a routine 2 D echocardiography were included in the analysis. Right heart catheterizations, pulmonary function testing, and exercise data was available for further analysis.

RESULTS:  24 (13 male and 11 female) patients met the inclusion criteria with TRJV ≥ 2.5 m/s and mean age of 36.7 ± 11 years. 21 patients had diagnosis of HbSS, 2 HbSC and 1 HbS/beta-thalasemia. 11 patients were diagnosed with acute chest syndrome in the past 5 years. Echocardiogram showed a mean ejection fraction of 58 ± 5 and mean TRJV of 2.89 ± 0.47 m/s. Seven (35%) of these patients had mean pulmonary artery pressure mPAP > 25mmHg. Out of these 7 patients only 3 (10%) had PCWP ≤ 15 mmHg. When compared with patients without pulmonary hypertension, patients with pulmonary hypertension had higher TRJV (3.2 ± 0.73 VS 2.73 ± 0.15), and higher cardiac output (10.38 ± 2.98 VS 7.85 ± 1.96 L/m). All the patients pulmonary hypertension had restrictive lung physiology (TLC < 80 % predicted) vs 8 (61 %) of the patients without pulmonary hypertension. DLCO was significantly reduced in all patients (mean 20.67 ± 5.73).

CONCLUSION:  The prevalence of pulmonary hypertension in sickle cell disease patients with TRJV ≥ 2.5 m/sec is 35%. One third had pulmonary arterial hypertension, and 2/3 had pulmonary venous hypertension. Almost all patients with pulmonary hypertension had TRJV > 2.7 m/sec. Restrictive lung physiology and history of acute chest syndrome is common among patients who suffer from pulmonary hypertension.

CLINICAL IMPLICATIONS:  The prevalence of pulmonary hypertension in sickle cell disease patients is significant. Further emphasis on screening and evaluation is warranted.

DISCLOSURE:  Mohammad Al-Ali, No Financial Disclosure Information; No Product/Research Disclosure Information

Tuesday, November 3, 2009

12:45 PM - 2:00 PM


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