RESUMO
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. 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. 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. Raised PASP was common in Kuwaiti SCD patients while raised TRJV was not