Sickle Cell Disease Clinical Trial
Official title:
Evaluation of the Characteristics, Prevalence and Prognosis of Pulmonary Hypertension in Adult Patients With Sickle Cell Disease: Study ETENDARD.
Recent data show that pulmonary hypertension (PH), defined by a tricuspid regurgitation jet (TRJ) velocity > or equal at 2.5m/s on Doppler echocardiography, is present in about 30% of adults with sickle cell disease (SCD) and is associated with poor prognosis. However in SCD the occurrence of PH (defined by mean pulmonary arterial pressure (mPAP)> or equal at 25 mmHg) is related to at least 3 mechanisms: PH due to hyperkinetic state with high cardiac output (CO) but normal pulmonary vascular resistance (PVR <160 dynes), or postcapillary PH (pulmonary capillary wedge pressure PCWP >15 mmHg), or precapillary pulmonary arterial hypertension (PAH) defined by mPAP > or equal at 25 mmHg, PCWP< or equal at 15 mmHg and PVR > or equal at 160 dynes.The aim of this study is to evaluate in a French population of adults with sickle cell disease the characteristics, prevalence and prognosis of pulmonary hypertension.
Consecutive adult patients with sickle cell disease (SCD) had a Doppler echocardiography to
evaluate if they had a suspected pulmonary hypertension (PH) on the basis of a tricuspid
regurgitation jet (TRJ) velocity > or equal at 2.5m/s. In this case, a right heart
catheterization was performed to confirm or not this diagnosis and its mechanisms. Each
included patient was followed every year for 3 years: during each visit, a clinical
evaluation was obtained and a Doppler echocardiography. In case of emergence of a suspected
PH, a right heart catheterization was performed to confirm or not this diagnosis and its
mechanisms.
Three groups of patients were defined: no PH, precapillary PH, and a third group including
post-capillary PH and hyperkinetic state. These groups were well defined on the basis of the
results of th Doppler echocardiography and right heart catheterisation.
Characteristics of patients and their prognosis were evaluated in each group.
In the same, way, biological study is planned to evaluate some biological markers of the
mechanism of PH, and prognostic factors.
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Observational Model: Cohort, Time Perspective: Prospective
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