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Association of Elevated Tricuspid Regurgitation Velocity with Cerebrovascular and Kidney Disease in Children with Sickle Cell Disease
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  • Chibuzo Ilonze,
  • Parul Rai,
  • Najibah Galadanci,
  • Rima Zahr,
  • Victoria Okhomina,
  • Guolian Kang,
  • Dakshin Padmanabhan,
  • Jeffrey Lebensburger,
  • Ammar Alishlash
Chibuzo Ilonze
The University of Alabama at Birmingham Department of Pediatrics

Corresponding Author:cilonze@uabmc.edu

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Parul Rai
St Jude Children's Research Hospital
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Najibah Galadanci
The University of Alabama at Birmingham Department of Medicine
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Rima Zahr
The University of Tennessee Health Science Center Department of Pediatrics
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Victoria Okhomina
St Jude Children's Research Hospital
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Guolian Kang
St Jude Children's Research Hospital
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Dakshin Padmanabhan
The University of Alabama at Birmingham Department of Pediatrics
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Jeffrey Lebensburger
The University of Alabama at Birmingham Department of Pediatrics
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Ammar Alishlash
The University of Alabama at Birmingham Department of Pediatrics
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Abstract

Background: Tricuspid regurgitation velocity (TRV), measured by echocardiography, is a surrogate marker for pulmonary hypertension. Limited pediatric studies have considered the association between TRV and surrogate markers of end-organ disease. Methods: Therefore, we conducted a cross-sectional study that evaluated the prevalence of elevated TRV ≥ 2.5 m/s and its associations with renal and cerebrovascular outcomes in children with SCD 1-21 years of age in two large sickle cell cohorts, the University of Alabama at Birmingham (UAB) sickle cell cohort, and the Sickle Cell Clinical and Research Intervention Program (SCCRIP) cohort at St. Jude Children’s Research hospital. We hypothesized that patients with sickle cell disease with elevated TRV would have higher odds of having either albuminuria or cerebrovascular disease. Results: We identified 166 children from the UAB cohort (mean age: 13.49 ± 4.47 years) and 325 children from the SCCRIP cohort (mean age: 13.41 ± 3.99 years) with echocardiography. The prevalence of an elevated TRV was 21% in both UAB and SCCRIP cohorts. Elevated TRV was significantly associated with cerebrovascular disease (OR 1.88 (95% CI: 1.12- 3.15)) and persistent albuminuria (OR: 1.81 (95% CI: 1.07– 3.06)) after adjusting for age, sex, treatment, and site. Conclusion: This cross-sectional, multicenter study identifies associations between surrogate markers of pulmonary hypertension with kidney disease and cerebrovascular disease. A prospective study should be performed to evaluate the longitudinal outcomes for patients with multiple surrogate markers of end-organ disease.
21 Sep 2023Submitted to Pediatric Blood & Cancer
21 Sep 2023Submission Checks Completed
21 Sep 2023Assigned to Editor
22 Sep 2023Review(s) Completed, Editorial Evaluation Pending
25 Sep 2023Reviewer(s) Assigned
27 Oct 2023Editorial Decision: Revise Major
14 Feb 2024Review(s) Completed, Editorial Evaluation Pending
08 Mar 20243rd Revision Received
08 Mar 2024Submission Checks Completed
08 Mar 2024Assigned to Editor
08 Mar 2024Review(s) Completed, Editorial Evaluation Pending