Transcranial Doppler in hemoglobin SC disease

Vieira, Carmen Baur; Oliveira, Carolina Nogueira Costa de; Figueiredo, Ludmila Araújo Borges de; Santiago, Rayra Pereira; Adanho, Corynne Stéphanie Ahouefa; Santana, Sânzio Silva; Burak, Caroline Lang; Lyra, Isa Menezes; Gonçalves, Marilda Souza

doi:10.1002/pbc.26342

Cited by 13 publications

(20 citation statements)

References 17 publications

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“…Vieira and colleagues [ 10 ] defined a cutoff value of 143.50 cm/s with respect to stroke risk in a sample with HbSC very similar to the present study. Using this value, 60 children with HbSC had low TAMMV, while 8 children had high TAMMV.…”

Section: Resultssupporting

confidence: 67%

“…Previous studies have evaluated individuals with HbSC and described an average TAMMV of 94 cm/s and 104.9 ± 19.3 cm/s [ 9 , 10 ]. In our study, we found that children with HbSC had an average TAMMV of 114.31 ± 22.72 cm/s.…”

Section: Discussionmentioning

confidence: 99%

“…All study subjects were submitted to TCD to assess CBFV, which was always performed by a single professional using the same equipment. The time-averaged maximum mean velocity (TAMMV) was measured in the middle cerebral (MCA), anterior cerebral (ACA), and distal intracranial internal carotid (ICA) arteries by a 2 MHz probe through the transtemporal window using a Doppler-Box™ X sonography system (Compumedics Germany GmbH, Singen, Hohentwiel, Germany) [ 7 , 9 , 10 ].…”

Section: Methodsmentioning

confidence: 99%

“…In a previous report that attempted to establish CBFV reference values for individuals with HbSC, Deane and colleagues [ 9 ] considered as elevated values those exceeding 128 cm/s. Another study on cerebral velocities in individuals with HbSC reported values lower than those described in individuals with SCA and proposed that velocities above 143.5 cm/s should be considered elevated [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

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Laboratory and Genetic Biomarkers Associated with Cerebral Blood Flow Velocity in Hemoglobin SC Disease

et al. 2017

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Reference values for cerebral blood flow velocity (CBFV) in hemoglobin SC disease (HbSC) have not been established. We aimed to investigate associations between laboratory and genetic biomarkers associated with CBFV in HbSC children. Sixty-eight HbSC children were included; CBFV was analyzed by transcranial Doppler, and the time-averaged maximum mean velocity (TAMMV) was estimated. Hematological, biochemical, immunological, and genetic analyses were performed. TAMMV was negatively correlated with red blood cell count (RBC) count, hemoglobin, hematocrit, and direct bilirubin (DB), yet positively correlated with monocytes and ferritin. We found that children with TAMMV ≥ 128 cm/s had decreased red blood cell distribution width (RDW) and nitric oxide metabolite (NOx) concentration. Children with TAMMV ≥ 143.50 cm/s had decreased hemoglobin and hematocrit, as well as increased ferritin levels. Decreased hemoglobin, hematocrit, RDW, and NOx and increased ferritin were detected in children with TAMMV ≥ 125.75 cm/s. The CAR haplotype was associated with higher TAMMV. In association analyses, RBC, hemoglobin, hematocrit, RDW, monocyte, DB, NOx, and ferritin, as well as the CAR haplotype, were found to be associated with higher TAMMV in HbSC children. Multivariate analysis suggested that high TAMMV was independently associated with hematocrit, RDW, and NOx. Additional studies are warranted to validate the establishment of a cutoff value of 125.75 cm/s associated with elevated TAMMV in HbSC children.

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Section: Resultssupporting

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Laboratory and Genetic Biomarkers Associated with Cerebral Blood Flow Velocity in Hemoglobin SC Disease

et al. 2017

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“…However, several studies have demonstrated that children with HbSC disease have significantly lower TCD velocities in MCA and ICA compared to children with SCA. A recent large Brazilian study has estimated the mean MCA TAMMV in HbSC disease to be 104 cm/s, with strong negative correlation with haemoglobin levels and haematocrit (Vieira et al , ) compared to mean MCA TAMMV of 129 cm/sec in a study of 190 HbSS patients (Adams et al , ). A smaller study in London reported a mean MCA velocity of 94 cm/s in HbSC patients with a significant positive correlation with platelet counts.…”

Section: Tcd In Hbscmentioning

confidence: 99%

How I manage sickle cell patients with high transcranial doppler results

2017

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Stroke is one of the most severe complications to affect children with sickle cell anaemia (SCA). Transcranial doppler (TCD) is an accurate and non-invasive method to determine stroke risk. Randomised controlled trials have demonstrated the efficacy of chronic transfusion therapy in stroke prevention based on risk stratification determined by TCD velocities. This has led to the regular use of TCD monitoring for children with SCA in order to determine stroke risk. Significant resource allocation is necessary to facilitate training, quality assurance and failsafe arrangements for non-attenders. In a subgroup of patients, chronic transfusions for primary stroke prevention can be replaced by hydroxycarbamide therapy, provided careful monitoring is undertaken; including repeat TCD studies at frequent intervals. The authors propose an evidence-based algorithm for the management of abnormal TCD velocities and discuss the role of this test in other clinical contexts, such as in Haemoglobin SC disease.

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