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The Effects of Hydroxyurea Therapy on the Six-Minute Walk Distance in Patients with Adult Sickle Cell Anemia: An Echocardiographic Study

BACKGROUND: The impact of hydroxyurea (HU) medication as treatment of choice has not been evaluated in adult sickle cell anemia (SCA) patients in terms of the 6-min walk distance (6 MWD). AIM: The aim of the study was evaluating the effects of HU on the 6 MWD, serum brain natriuretic peptide (NT-pro...

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Autores principales: Garadah, Taysir, Mandeel, Fatema, Jaradat, Ahmed, Bin Thani, Khalid
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6938284/
https://www.ncbi.nlm.nih.gov/pubmed/31920416
http://dx.doi.org/10.2147/JBM.S203828
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author Garadah, Taysir
Mandeel, Fatema
Jaradat, Ahmed
Bin Thani, Khalid
author_facet Garadah, Taysir
Mandeel, Fatema
Jaradat, Ahmed
Bin Thani, Khalid
author_sort Garadah, Taysir
collection PubMed
description BACKGROUND: The impact of hydroxyurea (HU) medication as treatment of choice has not been evaluated in adult sickle cell anemia (SCA) patients in terms of the 6-min walk distance (6 MWD). AIM: The aim of the study was evaluating the effects of HU on the 6 MWD, serum brain natriuretic peptide (NT-pro BNP) level, and pulmonary hypertension (PH) measured by tricuspid regurgitation velocity (TRV). METHODS: In this cross-sectional, prospective study, 110 patients with homozygous SCA were studied and compared with age- and gender-matched healthy controls. Every patient was investigated via pulsed and tissue Doppler echo evaluation, 6-min walk test (6 MWT), and blood level for the level of NT-pro-BNP hormone. Data were compared in patients with (n = 59; group 1, G1) and without (n = 51; group 2, G2) HU medication. Pearson correlation analysis was applied and clinical follow-up for the frequency of acute chest syndrome (ACS). Analysis of variance (ANOVA) multivariate statistical analysis was applied between groups. RESULTS: In the study, 110 patients with SCA were studied and compared with 110 control patients. Patients in G1 compared with G2 had a longer 6 MWD (491 ± 64.4 m vs 428.6 ± 54.3 m, p < 0.005), higher HbF% (21 ± 2.5% vs 8 ± 1.8%, p < 0.005), and lower NT-pro-BNP level (314.1 ± 27.5 pmol/L vs 407 ± 18.9 pmol/L, p = 0.05). The mean TRV values were 2.8 ± 0.5 m/s in G1 versus 3.4 ± 0.4 m/s in G2, p < 0.005, and 1.5 ± 0.7 m/s in the control group. The high probability of PH based on a TRV > 3.4 m/s was 10.1% in G1 versus 17.6% in G2 and 3.6% in the control. There were weak positive correlations between NT-pro-BNP and TRV (r = 0.264; p = 0.005) and HbF% and 6 MWD (r = 0.452; p = 0.001). After 12 months of follow-up, frequency of acute chest syndrome (ACS) was twice as high in G2, at 32 patients, versus 16 in G1. CONCLUSION: Patients with SCA on HU medication compared with no HU had significantly longer 6 MWD, lower level of NT-pro-BNP, higher HbF% level. After 1-year follow-up HU patients had less frequency of ACS. There were significant positive correlations between the level of NT-pro BNP level and TRV in m/s on echo.
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spelling pubmed-69382842020-01-09 The Effects of Hydroxyurea Therapy on the Six-Minute Walk Distance in Patients with Adult Sickle Cell Anemia: An Echocardiographic Study Garadah, Taysir Mandeel, Fatema Jaradat, Ahmed Bin Thani, Khalid J Blood Med Original Research BACKGROUND: The impact of hydroxyurea (HU) medication as treatment of choice has not been evaluated in adult sickle cell anemia (SCA) patients in terms of the 6-min walk distance (6 MWD). AIM: The aim of the study was evaluating the effects of HU on the 6 MWD, serum brain natriuretic peptide (NT-pro BNP) level, and pulmonary hypertension (PH) measured by tricuspid regurgitation velocity (TRV). METHODS: In this cross-sectional, prospective study, 110 patients with homozygous SCA were studied and compared with age- and gender-matched healthy controls. Every patient was investigated via pulsed and tissue Doppler echo evaluation, 6-min walk test (6 MWT), and blood level for the level of NT-pro-BNP hormone. Data were compared in patients with (n = 59; group 1, G1) and without (n = 51; group 2, G2) HU medication. Pearson correlation analysis was applied and clinical follow-up for the frequency of acute chest syndrome (ACS). Analysis of variance (ANOVA) multivariate statistical analysis was applied between groups. RESULTS: In the study, 110 patients with SCA were studied and compared with 110 control patients. Patients in G1 compared with G2 had a longer 6 MWD (491 ± 64.4 m vs 428.6 ± 54.3 m, p < 0.005), higher HbF% (21 ± 2.5% vs 8 ± 1.8%, p < 0.005), and lower NT-pro-BNP level (314.1 ± 27.5 pmol/L vs 407 ± 18.9 pmol/L, p = 0.05). The mean TRV values were 2.8 ± 0.5 m/s in G1 versus 3.4 ± 0.4 m/s in G2, p < 0.005, and 1.5 ± 0.7 m/s in the control group. The high probability of PH based on a TRV > 3.4 m/s was 10.1% in G1 versus 17.6% in G2 and 3.6% in the control. There were weak positive correlations between NT-pro-BNP and TRV (r = 0.264; p = 0.005) and HbF% and 6 MWD (r = 0.452; p = 0.001). After 12 months of follow-up, frequency of acute chest syndrome (ACS) was twice as high in G2, at 32 patients, versus 16 in G1. CONCLUSION: Patients with SCA on HU medication compared with no HU had significantly longer 6 MWD, lower level of NT-pro-BNP, higher HbF% level. After 1-year follow-up HU patients had less frequency of ACS. There were significant positive correlations between the level of NT-pro BNP level and TRV in m/s on echo. Dove 2019-12-27 /pmc/articles/PMC6938284/ /pubmed/31920416 http://dx.doi.org/10.2147/JBM.S203828 Text en © 2019 Garadah et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Garadah, Taysir
Mandeel, Fatema
Jaradat, Ahmed
Bin Thani, Khalid
The Effects of Hydroxyurea Therapy on the Six-Minute Walk Distance in Patients with Adult Sickle Cell Anemia: An Echocardiographic Study
title The Effects of Hydroxyurea Therapy on the Six-Minute Walk Distance in Patients with Adult Sickle Cell Anemia: An Echocardiographic Study
title_full The Effects of Hydroxyurea Therapy on the Six-Minute Walk Distance in Patients with Adult Sickle Cell Anemia: An Echocardiographic Study
title_fullStr The Effects of Hydroxyurea Therapy on the Six-Minute Walk Distance in Patients with Adult Sickle Cell Anemia: An Echocardiographic Study
title_full_unstemmed The Effects of Hydroxyurea Therapy on the Six-Minute Walk Distance in Patients with Adult Sickle Cell Anemia: An Echocardiographic Study
title_short The Effects of Hydroxyurea Therapy on the Six-Minute Walk Distance in Patients with Adult Sickle Cell Anemia: An Echocardiographic Study
title_sort effects of hydroxyurea therapy on the six-minute walk distance in patients with adult sickle cell anemia: an echocardiographic study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6938284/
https://www.ncbi.nlm.nih.gov/pubmed/31920416
http://dx.doi.org/10.2147/JBM.S203828
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