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Volume 350:2521-2522 June 10, 2004 Number 24
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Pulmonary Hypertension as a Risk Factor for Death in Patients with Sickle Cell Disease

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 by Gladwin, M. T.
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To the Editor: We commend Gladwin et al. (Feb. 26 issue)1 on their large prospective study of pulmonary hypertension in the population of patients with sickle cell disease. The pathogenesis of pulmonary hypertension in sickle cell disease remains unclear and is probably multifactorial. In general, elevated pulmonary-artery pressures occur most commonly because of left-sided heart disease, a well-described complication of sickle cell disease.2 Consequently, pulmonary hypertension has been defined as a mean pulmonary-artery pressure of 25 mm Hg at rest and a pulmonary-capillary wedge pressure of less than 15 mm Hg.3 The 18 patients who underwent catheterization had a mean . . . [Full Text of this Article]


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