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Tricuspid regurgitant jet velocity is associated with hemolysis in children and young adults with sickle cell disease evaluated for pulmonary hypertension

From the Division of Hematology, Oncology & Stem Cell Transplant (RIL, AAT); Division of Cardiology (LTY), Children’s Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA

Correspondence: Robert I. Liem, MD, Division of Hematology, Oncology & Stem Cell Transplant, Children’s Memorial Hospital, 2300 Children’s Plaza, Box 30, Chicago, 60614-3394, IL, USA. E-mail: rliem{at}childrensmemorial.org

Tricuspid regurgitant jet velocity (TRJV) 2.5 m/sec. on echocardiography is a surrogate marker for pulmonary hypertension (PHT) in adults with sickle cell disease (SCD). We prospectively examined the relationship between TRJV and laboratory markers of hemolysis in 51 children and young adults with SCD at baseline. We found significant correlations between TRJV and lactate dehydrogenase (LDH), hemoglobin (Hb), reticulocyte count (retic) and aspartate aminotransferase (AST). LDH, retic and AST were significantly higher and Hb was lower in subjects with TRJV 2.5 m/sec. We conclude that hemolysis significantly contributes to TRJV elevation in children and young adults with SCD.

Key words: sickle cell disease, pulmonary hypertension, tricuspid regurgitant jet velocity, hemolysis, lactate dehydrogenase.