Elevated tricuspid regurgitant jet velocity in children and adolescents with sickle cell disease: association with hemolysis and hemoglobin oxygen desaturation
Elevated tricuspid regurgitant jet velocity in children and adolescents with sickle cell disease: association with hemolysis and hemoglobin oxygen desaturation
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DOI：
10.3324/haematol.13812
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发表时间：
2009-03-01
期刊：
影响因子：
--
通讯作者：
Gordeuk, Victor R.
中科院分区：
文献类型：
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作者：
Minniti, Caterina R.;Sable, Craig;Gordeuk, Victor R.
超声心动图测定的三尖瓣反流速度升高可预测镰状细胞病成人患者的高收缩期肺动脉压和早期死亡率。在儿科患者中，喷射速度升高的定义、患病率和临床相关性尚未确定。本研究验证了以下假设：射流速度升高影响10%的儿科患者，与溶血和缺氧相关，并与急性胸部综合征、中风、输血需求和异常的6分钟步行试验结果。设计和方法一项前瞻性多中心研究，310例3- 20岁镰状细胞病患者在基础条件下和54名匹配的对照进行。溶血指数产生的乳酸脱氢酶，天冬氨酸氨基转移酶和胆红素和网织红细胞count.ResultsElevated喷射速度（定义为>= 2.60米/秒的基础上，平均+/- 2 SD在对照组）的水平的主成分分析发生在32例（11.0%），包括一个孩子的3岁。在调整血红蛋白浓度、收缩压和左心室舒张功能后，溶血指数增加2SD与射流速度升高（p=0.009）和氧饱和度升高的几率增加4.5倍相关
BackgroundElevation of echocardiography-determined tricuspid regurgitant jet velocity predicts high systolic pulmonary artery pressure and early mortality in adults with sickle cell disease. The definition, prevalence and clinical correlates of elevated jet velocity have not been established in pediatric patients. The present study tested the hypotheses that elevated jet velocity affects 10% of pediatric patients, is associated with both hemolysis and hypoxia, and has clinical correlates with acute chest syndrome, stroke, transfusion requirement and abnormal 6-minute walk test results.Design and MethodsA prospective multicenter study of 310 patients aged 3-20 years old with sickle cell disease under basal conditions and 54 matched controls was conducted. A hemolytic index was generated by principal component analysis of the levels of lactate dehydrogenase, aspartate aminotransferase and bilirubin and reticulocyte count.ResultsElevated jet velocity (defined as >= 2.60 m/sec based on the mean +/- 2 SD in controls) occurred in 32 patients (11.0%) including one child of 3 years old. After adjustment for hemoglobin concentration, systolic blood pressure and left ventricular diastolic function, a 2 SD increase in the hemolytic index was associated with a 4.5-fold increase in the odds of elevated jet velocity (p=0.009) and oxygen saturation