Methodological Contributions about Systolic Pulmonary Artery Pressure
Another point with regard to the PASP measurement of the patients in this study was made of tricuspid regurgitant jet. At the same time, the mean tricuspid regurgitant jet velocity was 1.7 ± 0.5 m/s in the patient population. When this value was analyzed, it gave the impression that sufficient flow was not obtained over the tricuspid valve. For this reason, since guidelines recommend to use contrast echocardiography with agitated saline in subjects where the measurement of tricuspid regurgitant jet velocity is difficult (insignificant/mild tricuspid regurgitant), we think this procedure would have enabled them to make a more appropriate evaluation by augmenting Doppler signals significantly [4] , thus giving an opportunity to measure PASP in SCD patients more accurately. In conclusion, we congratulate the authors for this original trial and hope it could pioneer other studies like this. Dear Editor, We have read the article by Marouf et al. [1] entitled ‘Transthoracic echocardiography and 6-min walk test in Kuwaiti sickle cell disease patients’ with great interest. The authors had evaluated echocardiographic parameters and 6-min walk test results in patients with sickle cell disease (SCD) living in Kuwait. As a result of the study, when compared with healthy volunteers, a marked decrease in 6-min walk test distance was seen in SCD patients. Also, pulmonary artery systolic pressure (PASP) was over 30 mm Hg in only 8% of SCD patients. The study is noteworthy in terms of pointing out cardiac problems in SCD patients. Nevertheless, there are some aspects of the study that need further explanation. First, there should have been a table showing baseline characteristics, where patient and control groups were compared statistically. This table should have provided enough information on age, sex, body mass index and smoking status because it must be taken into consideration that physiologic range of PASP varies with age, sex and body mass index. Moreover, PASP can be considered normal until 40 mm Hg in the elderly and obese [2] . The effect of smoking on PASP is evident [3] . That is why it could have been more valuable to see those data in this trial. Published online: September 25, 2015