镰状细胞病的心血管后果。

IF 2.1 Q3 HEMATOLOGY
Journal of Blood Medicine Pub Date : 2024-05-06 eCollection Date: 2024-01-01 DOI:10.2147/JBM.S455564
Salem Bahashwan, Rahaf Mohammad Almuhanna, Maryam Taher Al Hazza, Reem Wajdi Baarma, Abdulrahman Yousif AlNajjar, Faris Sameer Siddiqui, Shouq Ziyad Fatani, Ahmed Barefah, Hatem Alahwal, Abdullah Almohammadi, Osman Radhwi, Alaa S Algazzar, Eman M Mansory
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引用次数: 0

摘要

背景:镰状细胞病是一种遗传性血液疾病,可导致严重的并发症,尤其是心血管和呼吸系统的并发症,可能导致心律失常、肺动脉高压(PH)和心脏肥大。本研究旨在调查成年 SCD 患者 PH 和心律失常的风险:回顾性分析阿卜杜勒阿齐兹国王大学医院(KAUH)2009 年至 2021 年期间 15 岁及以上 SCD 患者的医疗记录。研究纳入了 517 名患者,并根据欧洲心脏病学会/欧洲呼吸学会(ESC/ERS)关于 PH 风险分类(低、中、高)和检测心律失常的指南对超声心动图和心电图进行了评估。数据分析采用社会科学统计软件包(SPSS),利用定量和定性数据表示。多变量逻辑回归确定了独立的风险因素,其几率比为 95% 的置信区间 (CI):参与者中,50.3%为男性,样本平均年龄为(34.45 ± 9.28)岁。结果显示,1.4%的患者有心律失常,3.7%的患者有中度PH风险,3.3%的患者被归类为高PH风险。逻辑回归显示,SCD 患者 PH 和心律失常的独立风险因素显著,其中慢性肾脏疾病(CKD)的几率最高(PH 几率是 CKD 的 26.4 倍,心律失常几率是 CKD 的 15.36 倍):结论:SCD 患者有患 PH 和各种心律失常的风险,但往往诊断不足。PH的主要风险因素包括慢性肾脏病、肝硬化和原有心脏病。心律失常与慢性肾功能衰竭和原有心脏疾病密切相关。为了降低这些风险,我们建议让多学科医疗团队参与 SCD 成年患者的护理。建议今后开展前瞻性研究,以便及早发现血红蛋白病患者的 PH 和心律失常,从而降低死亡率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cardiovascular Consequences of Sickle Cell Disease.

Background: Sickle cell disease is an inherited blood disorder which can lead to severe complications, particularly in the cardiovascular and respiratory systems, potentially resulting in arrhythmias, pulmonary hypertension (PH), and cardiomegaly. This study aims to investigate the risk of PH and arrhythmias in adult SCD patients.

Methods: Retrospective analysis of medical records from King Abdulaziz University Hospital (KAUH) for patients with SCD aged 15 and above between 2009 and 2021. The study included 517 patients, with echocardiograms and electrocardiograms assessed according to the European Society of Cardiology/the European Respiratory Society (ESC/ERS) guidelines for categorizing PH risk (low, moderate, high) and detecting arrhythmias. Data analysis employed the Statistical Package for the Social Sciences (SPSS), utilizing quantitative and qualitative data representation. Multivariate logistic regression identified independent risk factors with odds ratios at a 95% confidence interval (CI).

Results: Among participants, 50.3% were male, with a total sample average age of 34.45 ± 9.28 years. Results indicated that 1.4% of patients experienced arrhythmias, 3.7% had a moderate PH risk, and 3.3% were classified as high PH risk. Logistic regression revealed significant independent risk factors for PH and arrhythmia in patients with SCD, with chronic kidney disease (CKD) carrying the highest odds (26.4 times higher odds of PH and 15.36 times higher odds of arrhythmias).

Conclusion: Patients with SCD are at risk for developing PH and various arrhythmias but are often underdiagnosed. Key risk factors for PH included CKD, liver cirrhosis, and pre-existing cardiac conditions. Arrhythmias were significantly associated with CKD and pre-existing cardiac conditions. To mitigate these risks, we recommend involving a multidisciplinary healthcare team in the care of adult patients with SCD. Future prospective studies are advised for early detection of PH and arrhythmias in hemoglobinopathy patients, potentially reducing mortality.

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来源期刊
CiteScore
3.50
自引率
0.00%
发文量
94
审稿时长
16 weeks
期刊介绍: The Journal of Blood Medicine is an international, peer-reviewed, open access, online journal publishing laboratory, experimental and clinical aspects of all topics pertaining to blood based medicine including but not limited to: Transfusion Medicine (blood components, stem cell transplantation, apheresis, gene based therapeutics), Blood collection, Donor issues, Transmittable diseases, and Blood banking logistics, Immunohematology, Artificial and alternative blood based therapeutics, Hematology including disorders/pathology related to leukocytes/immunology, red cells, platelets and hemostasis, Biotechnology/nanotechnology of blood related medicine, Legal aspects of blood medicine, Historical perspectives. Original research, short reports, reviews, case reports and commentaries are invited.
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