AbdelMassih Antoine Fakhry, Nabil Fatima, Salama Niveen, Youssry Ilham
Pediatric Cardiology Unit, Pediatrics Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Pediatric Department, Pediatric Cardiology Division, Specialized Pediatric Hospital, Faculty of Medicine, Cairo University, Kasr Al Ainy Street, Cairo, 12411, Egypt.
BMC Pediatr. 2025 May 14;25(1):382. doi: 10.1186/s12887-025-05689-3.
Right ventricle (RV) dysfunction because of pulmonary vasculopathy is the most common cause of death in sickle cell disease (SCD). This study aimed to explore the diagnostic accuracy of blood-speckle tracking and vortex detection in the early detection of pulmonary vasculopathy in patients with SCD.
This study was conducted as a cross-sectional study including thirty patients and thirty controls. Patients with SCD were examined using 3D echocardiography to determine the presence of RV dysfunction, as a surrogate of pulmonary vasculopathy: in addition to blood speckle tracking echocardiography to determine the vortex timing in the RV and its presence or absence in the pulmonary artery. Patients' demographic and hematologic data were also retrieved from patients' files.
Pulmonary vortex formation was 100% sensitive in the detection of RV dysfunction. LDH (Lactate Dehydrogenase) was the only variable significantly different between cases with pulmonary vortex formation and those without (520 vs. 257, P < 0.001), LDH > 400 was 72% sensitive and 100% specific in the detection of pulmonary vortex formation.
Pulmonary vortex formation was a sensitive indicator of RV dysfunction, thus suggesting its accuracy in the early detection of early pulmonary vascular changes in SCD. LDH as a marker of intravascular hemolysis, is a sensitive marker that can be used for risk stratification of SCD patients.
因肺血管病变导致的右心室功能障碍是镰状细胞病（SCD）最常见的死亡原因。本研究旨在探讨血流散斑追踪和涡旋检测在SCD患者肺血管病变早期检测中的诊断准确性。
本研究为横断面研究，纳入30例患者和30例对照。对SCD患者进行三维超声心动图检查以确定右心室功能障碍的存在，作为肺血管病变的替代指标：此外，还进行血流散斑追踪超声心动图检查以确定右心室的涡旋时间及其在肺动脉中的存在与否。患者的人口统计学和血液学数据也从患者病历中获取。
肺涡旋形成在检测右心室功能障碍方面的敏感性为100%。乳酸脱氢酶（LDH）是有肺涡旋形成和无肺涡旋形成的病例之间唯一有显著差异的变量（520对257，P<0.001），LDH>400在检测肺涡旋形成方面的敏感性为72%，特异性为100%。
肺涡旋形成是右心室功能障碍的敏感指标，表明其在SCD早期肺血管变化的早期检测中具有准确性。LDH作为血管内溶血的标志物，是一种可用于SCD患者风险分层的敏感标志物。
