Transcranial Doppler Ultrasound in Peninsular Arab Patients With Sickle Cell Disease

Adekile, Adekunle; Hassan, Abdul Kareem F.; Asbeutah, Akram M.; Al-Hinai, Mohamed; Trad, Omar; Farhan, Nayef

doi:10.1002/jum.14680

Cited by 12 publications

(18 citation statements)

References 38 publications

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“…Ashley-Koch et al showed that the US incidence of median survival by genotype was higher in females than in males with SCD [11]. However, Adekile A et al showed, no consistent differences in TCD velocity between male and female patients or in patients with different HbS genotypes [28]. In the current study, the correlation of HbS genotypes with TCD velocities, which in turn correlate with risk of cerebrovascular events, was not significant.…”

Section: Discussioncontrasting

confidence: 61%

Distribution of sickle cell disease and assessment of risk factors based on transcranial Doppler values in the Gulf region

2020

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Background/Objective: Stroke is a potentially fatal complication of sickle cell disease (SCD). Transcranial Doppler (TCD) is useful at identifying increased risk of stroke in children with SCD and vasospasm after subarachnoid hemorrhage. The main aim of this study was to determine the proportion of patients with SCD in the Gulf region who are at a high risk of stroke, as determined by TCD. Methods: This multicenter (Oman, Qatar, and UAE), descriptive, cross-sectional study in patients (aged 2-16 years) with SCD included a baseline visit, 1 follow-up visit for patients with conditional TCD, and 3-year retrospective data analysis for all patients. Results: Of the 410 eligible patients (Oman, 86.5%; Qatar, 8.2%; UAE, 5.1%), most had a TCD finding (left side, 91.7%; right side, 92.0%) of normal velocity (<155 cm/s) at baseline. For 6 of 7 patients with conditional velocity (155-179 cm/s) and 1 patient with high velocity (≥180 cm/s), baseline TCD results were not confirmed at follow-up. As per bivariate linear regression, age, race, transfusion type, and transfusion frequency were significant predictors of the TCD velocities. Multivariate logistic regressions revealed that TCD velocities were significantly correlated with sex, race, and type of transfusion. No patients reported any adverse events at follow-up. No deaths occurred during the study. Discussion/Conclusions: The study results show that far fewer patients with SCD in the Gulf have abnormal TCD findings than the internationally reported. Larger studies are needed to identify the factors underlying this observation.

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Section: Discussioncontrasting

confidence: 61%

Distribution of sickle cell disease and assessment of risk factors based on transcranial Doppler values in the Gulf region

2020

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“…In our present and previous studies, we did not encounter any individual with TAMxV higher than 170 cm/s. Indeed, the highest TAMxV was 145 cm/s in the MCA of one SCD patient, while the lowest was 65 cm/s in another patient also in the MCA without MRI evidence of stenosis.…”

Section: Discussionmentioning

confidence: 99%

Pattern of cerebral blood flow and the interrelationship of vascular parameters of transcranial Doppler imaging in children with sickle cell disease

Asbeutah

Almajran

Adekile

2018

J of Clinical Ultrasound

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Purpose: We assessed the pattern of cerebral blood flow and the relationship between the different transcranial Doppler imaging (TCDI) vascular parameters in children with sickle cell disease (SCD).Methods: Forty-three SCD pediatric patients with a stable condition (21 HbSS, 19 HbSβ 0 Thal, and 3 HbSD), aged 10.1 AE 3.9 years were studied. A control group of 26 with age and sexmatched, were included for comparison. TCDI scanning was carried out using a phased array transducer of 1-3 MHz through the trans-temporal window. Peak systolic velocity (PSV), end diastolic velocity (EDV), time-averaged mean of the maximum velocity (TAMxV), pulsatility index (PI), and resistive index (RI) were in the anterior circle of Willis vessels and posterior cerebral artery. Results: The highest mean AE SD values for the middle cerebral artery PSV, EDV, TAMxV, PI, and RI were 130.30 + 26.5, 145.0 AE 21.9; 58.60 + 13.70, 67.90 AE 13.3; 84.90 + 14.50, 94.80 AE 17.9; 0.95 + 0.20, 0.80 AE 0.20; 0.58 + 0.09, 0.50 AE 0.10 in the control and SCD groups, respectively. Independent t-test showed significant difference (P < .05) for all vascular parameters in all vessels in each side between both groups. There was a positive significant correlation between TAMxV, PSV, and EDV (P = .001, r = .96), and a negative significant correlation between TAMxV and PI in the SCD group (P = .001, r = −.46) but not in the control group (P > .05, r = −.62).Conclusions: There was a direct relationship between TAMxV and PSV and EDV, and an inverse relationship between TAMxV and PI in a group of SCD patients with normal TCDI values. K E Y W O R D S end-diastolic velocity, peak systolic velocity, pulsatility index, resistive index, sickle cell disease, stroke, time-averaged mean of the maximum velocity, transcranial Doppler imaging

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“…Further investigation of the CNS involvement showed mostly normal transcranial Doppler values among the patients [49]. Indeed, in a collaborative study with other countries in the region (Oman, Iraq, and UAE), transcranial Doppler values were generally normal [50]. It was also shown that silent brain infarcts are seen in about 3% of Kuwaiti children with SCD, while in adults, the prevalence is ∼20% [51,52].…”

Section: Scd In Kuwaitmentioning

confidence: 95%

The Genetic and Clinical Significance of Fetal Hemoglobin Expression in Sickle Cell Disease

Adekile

2020

Med Princ Pract

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Highlights of the Study• Sickle cell disease is clinically heterogeneous.• HbF is an important genetic modulating factor; however, several quantitative trait loci modify its expression. • Kuwaiti patients uniformly express elevated HbF levels, but the factors responsible for this are not clear and may be different from published reports. • This review addresses these issues in an in-depth and critical manner.

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Transcranial Doppler Ultrasound in Peninsular Arab Patients With Sickle Cell Disease

Abstract: This study has demonstrated the rarity of abnormal transcranial Doppler findings among Peninsular Arab patients with SCD. The guidelines for transcranial Doppler screening in this population need further studies and recommendations.

Cited by 12 publications

References 38 publications

Distribution of sickle cell disease and assessment of risk factors based on transcranial Doppler values in the Gulf region

Distribution of sickle cell disease and assessment of risk factors based on transcranial Doppler values in the Gulf region

Pattern of cerebral blood flow and the interrelationship of vascular parameters of transcranial Doppler imaging in children with sickle cell disease

The Genetic and Clinical Significance of Fetal Hemoglobin Expression in Sickle Cell Disease

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