Pulmonary hypertension screening in children with sickle cell disease

被引:2
作者
Chan, Kok Hoe [1 ]
Rizvi, Syeda Hiba [2 ,3 ]
De Jesus-Rojas, Wilfredo [4 ,5 ]
Stark, James M. [2 ,3 ]
Mosquera, Ricardo A. [2 ,3 ]
Prada-Ruiz, Adriana Carolina [2 ,3 ]
Gonzales, Traci [6 ]
Brown, Deborah L. [2 ,3 ]
Menon, Neethu M. [2 ,3 ]
Nguyen, Trinh T. [6 ]
Jon, Cindy K. [2 ,3 ]
Yadav, Aravind [2 ,3 ]
机构
[1] Univ Texas Hlth Sci Ctr Houston UTHlth Houston, McGovern Med Sch, Dept Internal Med, Div Hematol Oncol, Houston, TX 77030 USA
[2] Univ Texas Hlth Sci Ctr Houston UTHlth Houston, McGovern Med Sch, Dept Pediat, 6431 Fannin St,MSB 3-228, Houston, TX 77030 USA
[3] Childrens Mem Hermann Hosp, 6431 Fannin St,MSB 3-228, Houston, TX 77030 USA
[4] Ponce Hlth Sci Univ, Ponce, PR USA
[5] Ponce Res Inst, Sch Med, Dept Pediat & Basic Sci, Ponce, PR USA
[6] Baylor Coll Med, Dept Pediat, Houston, TX 77030 USA
关键词
BNP; ECHO; proBNP; pulmonary hypertension; screening; sickle cell disease; NATRIURETIC PEPTIDE LEVELS; CORONARY-ARTERY DILATION; DIASTOLIC DYSFUNCTION; RISK-FACTOR; FOLLOW-UP; DEATH; ASSOCIATION; VELOCITY; SOCIETY; CARDIOPULMONARY;
D O I
10.1002/pbc.29980
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background Screening for pulmonary hypertension (PHT) is recommended in children with sickle cell disease (SCD). However, best approaches are poorly described. We examined the utility of PHT symptoms, echocardiogram (ECHO), N-terminal-pro hormone brain natriuretic peptide (NT-proBNP), and BNP to screen for PHT in the SCD pediatric population. Methods Children (8-18 years old) with SCD-HbSS and HbSthal degrees were prospectively included and underwent PHT screening. The screening consisted of a comprehensive PHT symptoms evaluation, ECHO measurement, and NT-proBNP and BNP levels. Results A total of 73 patients were included (mean age 12 +/- 5.7 years; >80% on hydroxyurea), of which 37% had a symptom consistent with PHT, including exertional dyspnea (26.5%), fatigue (17.6%), palpitation (14.7%), and chest pain (10.3%). ECHO was obtained in 53 (72.6%) patients, with only ECHO of 48 patients included in the final analysis. Elevated ECHO peak tricuspid regurgitant jet velocity (TRV) >2.5 m/s or indirect findings to suggest PHT were seen in only two of 48 (4.2%). No significant differences were seen between those with and without PHT symptoms when compared for NT-proBNP, BNP, hemoglobin, pulmonary function testing, fractional exhaled nitric oxide, asthma, oxygen saturation, and sleep apnea. Conclusion PHT symptoms are not consistent with ECHO, NT-proBNP nor BNP findings in children with SCD. PHT prevalence based on TRV was low in children on hydroxyurea, therefore screening may not be warranted for this group.
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页数:6
相关论文
共 36 条
[1]   Pediatric Pulmonary Hypertension Guidelines From the American Heart Association and American Thoracic Society [J].
Abman, Steven H. ;
Hansmann, Georg ;
Archer, Stephen L. ;
Ivy, D. Dunbar ;
Adatia, Ian ;
Chung, Wendy K. ;
Hanna, Brian D. ;
Rosenzweig, Erika B. ;
Raj, J. Usha ;
Cornfield, David ;
Stenmark, Kurt R. ;
Steinhorn, Robin ;
Theobaud, Bernard ;
Fineman, Jeffrey R. ;
Kuehne, Titus ;
Feinstein, Jeffrey A. ;
Friedberg, Mark K. ;
Earing, Michael ;
Barst, Robyn J. ;
Keller, Roberta L. ;
Kinsella, John P. ;
Mullen, Mary ;
Deterding, Robin ;
Kulik, Thomas ;
Mallory, George ;
Humpl, Tilman ;
Wessel, David L. .
CIRCULATION, 2015, 132 (21) :2037-2099
[2]   Echocardiographic Screening of Cardiovascular Status in Pediatric Sickle Cell Disease [J].
Allen, Kiona Y. ;
Jones, Shannon ;
Jackson, Tannoa ;
DeCost, Grace ;
Stephens, Paul ;
Hanna, Brian D. ;
Cohen, Meryl S. ;
Smith-Whitley, Kim ;
Mercer-Rosa, Laura ;
Natarajan, Shobha S. .
PEDIATRIC CARDIOLOGY, 2019, 40 (08) :1670-1678
[3]  
[Anonymous], 2014, Evidence-based management of sickle cell disease: Expert panel report
[4]   Pulmonary hypertension in patients with sickle cell disease: a longitudinal study [J].
Ataga, Kenneth I. ;
Moore, Charity G. ;
Jones, Susan ;
Olajide, Oludamilola ;
Strayhorn, Dell ;
Hinderliter, Alan ;
Orringer, Eugene P. .
BRITISH JOURNAL OF HAEMATOLOGY, 2006, 134 (01) :109-115
[5]   Estimated pulmonary artery systolic pressure and sickle cell disease: a meta-analysis and systematic review [J].
Caughey, Melissa C. ;
Poole, Charles ;
Ataga, Kenneth I. ;
Hinderliter, Alan L. .
BRITISH JOURNAL OF HAEMATOLOGY, 2015, 170 (03) :416-424
[6]   Echocardiographic parameters to identify sickle cell patients with cardio-pathology [J].
Chiadika, Simbo ;
Lim-Fung, Mary ;
Llanos-Chea, Fiorella ;
Canache, Astrid Serauto ;
Yang, Wei ;
Paruthi, Christina ;
Zhang, Xu ;
McPherson, David D. ;
Idowu, Modupe .
ECHOCARDIOGRAPHY-A JOURNAL OF CARDIOVASCULAR ULTRASOUND AND ALLIED TECHNIQUES, 2018, 35 (09) :1271-1276
[7]   Pulmonary hypertension associated with sickle cell disease: Clinical and laboratory endpoints and disease outcomes [J].
De Castro, Laura M. ;
Jonassaint, Jude C. ;
Graham, Felicia L. ;
Ashley-Koch, Allison ;
Telen, Marilyn J. .
AMERICAN JOURNAL OF HEMATOLOGY, 2008, 83 (01) :19-25
[8]   Longitudinal analysis of cardiac abnormalities in pediatric patients with sickle cell anemia and effect of hydroxyurea therapy [J].
Dhar, Arushi ;
Leung, Tung Ming ;
Appiah-Kubi, Abena ;
Gruber, Dorota ;
Aygun, Banu ;
Serigano, Olivia ;
Mitchell, Elizabeth .
BLOOD ADVANCES, 2021, 5 (21) :4406-4412
[9]   Increased Left Main Coronary Artery Dimensions in Children With Sickle Cell Disease [J].
Doshi, Arpan R. ;
Pauliks, Linda B. .
PEDIATRIC CARDIOLOGY, 2013, 34 (04) :954-958
[10]   NT-proBNP levels and cardiopulmonary function in children with sickle cell disease [J].
Feld, Lance ;
Fiorino, Elizabeth K. ;
Aygun, Banu ;
Appiah-Kubi, Abena ;
Mitchell, Elizabeth C. ;
Jackson, Stacey ;
Mehran, Roxana ;
Fishbein, Joanna ;
Santiago, Maria T. .
PEDIATRIC PULMONOLOGY, 2021, 56 (02) :495-501