Arterial stiffness and pulse wave reflection in young adult heterozygote sickle cell anemia carriers

Objective: Pulse wave velocity and aortic augmentation index, indicators of arterial stiffness are non invasive methods for detecting the severity as vascular injury. However the progress of this parameters in heterozygote sickle cell anemia patients is unknown. The purpose is to evaluate the change in aortic pulse wave velocity (PWVao) a nd in young adult heterozygote sickle cell anemia carriers.Material and methods: We enrolled 40 volunteers (20 HbAS, 20 HbAA) between ages 18-40. All participants? medical history was taken. Physical and echocardiographic examinations were performed, blood pressure was measured. Augmentation index and PWVao values were measured using arteriograph.Results: Lower mean cell volume, mean cell hemoglobin (p=0.000), and higher red cell distrubition width (p=0.035) values were found in sickle cell anemia carriers. Aortic systolic diameter, aortic blood pressure, aortic augmentation index, brachial augmentation index, systolic-diastolyc pulse wave velocity difference values were found in sickle cell anemia carries in comparison to control group(consecutively p=0.000, 0.033, 0.011, 0.011, 0.040). Statistically significant positive correlation relationship was found between aortic pulse wave velocity and mean arterial pressure, age, aortic augmentation index, brachial augmentation index, weight, low dansity lipoprotein, and between aortic augmentation index and age in both groups (consecutively p= 0.000, 0.017, 0.000, 0.000, 0.034, 0.05, 0.026).. Positive correlation relationship was found between aortic pulse wave velocity and systolic blood pressure, weight, age (consecutively p=0.027,0.027, 0.016), and negative correlation relationship was found between aortic augmentation index and potassium in hemoglobin AS group (p=0.007). Statistically meaningful positive correlation was found between aortic pulse wave velocity and potassium in hemoglobin AA group (p= 0.028). Our study revealed that mean arterial pressure and heart rate are independent determinants for aortic augmentation index and mean arterial pressure and age are independent determinants for aortic pulse wave velocity.Conclusion: Aortic sistolic diameter, central blood pressure, aortic augmentation index, brachial augmentation index and systolic-diastolyc PWV difference were significantly higher in HbAS group. Arterial stiffness measurement is an easy, cheap and reliable method in early diagnosis of cardiovascular desease in heterozygot SCD carriers.Keywords: Sickle cell anemia carrier, augmentation index, pulse wave velocity