Elevated tricuspid regurgitation velocity in adults with sickle cell disease and HbAA controls in Kinshasa, Democratic Republic of the Congo: a comparative cross-sectional study

Pulmonary hypertension is a severe complication of sickle cell disease (SCD) and is associated with increased morbidity and mortality. Elevated tricuspid regurgitation velocity (TRV) assessed by echocardiography is commonly used as a screening marker to estimate the risk of pulmonary hypertension in adults with SCD. The objective of this study was to determine the prevalence of elevated TRV and to identify factors associated with elevated TRV in adults with sickle cell disease compared with HbAA clinical controls in Kinshasa. We conducted a comparative cross-sectional study between January 2024 and January 2025 including 71 adults with SCD in steady state (SCD excluding HbSC) and 71 HbAA clinical controls, individually matched by age (± 5 years) and sex. Participants were recruited independently of TRV status. Sociodemographic, clinical, biological, and echocardiographic data were collected. Transthoracic Doppler echocardiography was performed and TRV was measured from multiple ac in the absence of right heart catheterization to assess PH, with the highest value retained. Elevated TRV was defined as TRV ≥ 2.9 m/s. Logistic regression analyses were used to identify factors independently associated with elevated TRV. The mean age was 31.8 ± 5.8 years in the SCD group and 32.8 ± 5.6 years in controls. The overall prevalence of elevated TRV was 10.6%, and was significantly higher among patients with SCD (18.3%) compared with HbAA controls (2.8%, p 6 mg/L) (aOR 2.79, 95% CI 1.98–3.88). Elevated TRV, a marker of increased risk for pulmonary hypertension, was observed in nearly one in five adults with sickle cell disease in Kinshasa. Sickle cell disease status, systemic arterial hypertension, and systemic inflammation were independently associated with elevated TRV.