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Title	Hematological, physiologic, and anthropometric variables associated with transcranial doppler (TCD) ultrasound velocity and blood pressure analysis among sickle cell children and adolescents with abnormal TCD velocity
Author	De Angulo, Guillermo Alberto
Date	2011
Affiliation/College	College of Graduate Studies
Extent	Thesis. College of Graduate Studies. Program in Clinical Research. v, 45 leaves : ill.; 29 cm
Source	WH 170 D278 2011
Subject.MeSH	Academic Dissertations--South Carolina Ultrasonography Doppler Transcranial Anemia, Sickle Cell Stroke Academic Dissertations
Collection	MUSC Theses and Dissertations
Contributing Institution	Waring Historical Library (MUSC)
Rights	Copyright is held by the author.
Language	English
Type	Text
Format	application/pdf
Media Type	Manuscripts
Resource Identifier	mtd2011_deangulo_ga
Abstract	Introduction: Stroke is a serious complication of sickle cell disease (SCD) that has been associated with an increased transcranial Doppler (TCD) ultrasound velocity and increased systolic blood pressure. However, specific blood pressure profiles for children and adolescents with SCD are not available. Additionally, while previous studies have shown correlations between clinical or laboratorial factors and TCD velocity, there are many other variables that should be examined. The present study provides a profile of blood pressures and examines potential factors that can influence the development of abnormal TCD. Methods: This was a retrospective review of 120 sickle cell children and adolescents derived from the STOP I clinical trial. Hematological, anthropometric and physiologic data was used to examine the correlation between TCD velocity and variables using Pearson’s correlation, simple linear and multivariate regression analysis. Furthermore, we developed a blood pressure profile of sickle cell patients with an abnormal TCD velocity. Results: In the study the median age was 7.9 with 47% being male. We subsequently divided the cohort in two subgroups based on age (</= 8 years old, and >8 years old). The median systolic blood pressure was higher in sickle cell patients when compared to gener and age-matched non-sickle cell children. Median diastolic blood pressures were predominately lower than gender and age-matched non-sickle cell children. However, it was higher in male patients who were </= 8 years old. There were no differences in the median mean arterial pressures, except in females and males </= 8 years old. Median pulse was predominately higher in sickle cell patients. Diastolic blood pressure was significantly associated with TCD velocity as a dependent variable in regression analysis. Conclusion: These results indicate that children and adolescents with sickle cell disease may have different blood pressure ranges in comparison to non-sickle cell individuals. Furthermore, our results show that increased diastolic blood pressure in sickle cell patients may be associated with risk of stroke in certain gender and age groups. Prospective studies are needed to determine if systolic, diastolic and mean arterial blood pressures should be considered when assessing stroke risk in sickle cell children and adolescents.

Hematological, physiologic, and anthropometric variables associated with transcranial doppler (TCD) ultrasound velocity and blood pressure analysis among sickle cell children and adolescents with abnormal TCD velocity

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