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\begin{document}

\title{Association of Elevated Tricuspid Regurgitation Velocity with
Cerebrovascular and Kidney Disease in Children with Sickle Cell Disease}



\author[1]{Chibuzo Ilonze}%
\author[2]{Parul Rai}%
\author[3]{Najibah Galadanci}%
\author[4]{Rima Zahr}%
\author[2]{Victoria Okhomina}%
\author[2]{Guolian Kang}%
\author[1]{Dakshin Padmanabhan}%
\author[1]{Jeffrey Lebensburger}%
\author[1]{Ammar Alishlash}%
\affil[1]{The University of Alabama at Birmingham Department of Pediatrics}%
\affil[2]{St Jude Children's Research Hospital}%
\affil[3]{The University of Alabama at Birmingham Department of Medicine}%
\affil[4]{The University of Tennessee Health Science Center Department of Pediatrics}%


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  \date{May 15, 2024}


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\selectlanguage{english}
\begin{abstract}
\textbf{Background:} Tricuspid regurgitation velocity (TRV), measured by
echocardiography, is a surrogate marker for pulmonary hypertension.
Limited pediatric studies have considered the association between TRV
and surrogate markers of end-organ disease. \textbf{Methods:} Therefore,
we conducted a cross-sectional study that evaluated the prevalence of
elevated TRV [?] 2.5 m/s and its associations with renal and
cerebrovascular outcomes in children with SCD 1-21 years of age in two
large sickle cell cohorts, the University of Alabama at Birmingham (UAB)
sickle cell cohort, and the Sickle Cell Clinical and Research
Intervention Program (SCCRIP) cohort at St. Jude Children's Research
hospital. We hypothesized that patients with sickle cell disease with
elevated TRV would have higher odds of having either albuminuria or
cerebrovascular disease. \textbf{Results:} We identified 166 children
from the UAB cohort (mean age: 13.49 \selectlanguage{ngerman}± 4.47 years) and 325 children from
the SCCRIP cohort (mean age: 13.41 ± 3.99 years) with echocardiography.
The prevalence of an elevated TRV was 21\% in both UAB and SCCRIP
cohorts. Elevated TRV was significantly associated with cerebrovascular
disease (OR 1.88 (95\% CI: 1.12- 3.15)) and persistent albuminuria (OR:
1.81 (95\% CI: 1.07-- 3.06)) after adjusting for age, sex, treatment,
and site. \textbf{Conclusion:} This cross-sectional, multicenter study
identifies associations between surrogate markers of pulmonary
hypertension with kidney disease and cerebrovascular disease. A
prospective study should be performed to evaluate the longitudinal
outcomes for patients with multiple surrogate markers of end-organ
disease.%
\end{abstract}\selectlanguage{ngerman}%



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\textbf{Hosted file}

\verb`Association of Elevated Tricuspid Regurgitation Velocity with Kidney and Cerebrovascular Disease in Children with Sickle Cell Disease 9.18.23 Final.docx`  available at \url{https://authorea.com/users/667687/articles/667816-association-of-elevated-tricuspid-regurgitation-velocity-with-cerebrovascular-and-kidney-disease-in-children-with-sickle-cell-disease}

\textbf{Hosted file}

\verb`Figure 1 Stepwise models for combined UAB and St. Jude cohort 8 29 23.docx`  available at \url{https://authorea.com/users/667687/articles/667816-association-of-elevated-tricuspid-regurgitation-velocity-with-cerebrovascular-and-kidney-disease-in-children-with-sickle-cell-disease}

\textbf{Hosted file}

\verb`Table 1 Sample Characteristics of Patients by Cerebrovascular Disease Status.docx`  available at \url{https://authorea.com/users/667687/articles/667816-association-of-elevated-tricuspid-regurgitation-velocity-with-cerebrovascular-and-kidney-disease-in-children-with-sickle-cell-disease}

\textbf{Hosted file}

\verb`Table 2 Sample Characteristics of Patients by Persistent Albuminuria Status.docx`  available at \url{https://authorea.com/users/667687/articles/667816-association-of-elevated-tricuspid-regurgitation-velocity-with-cerebrovascular-and-kidney-disease-in-children-with-sickle-cell-disease}

\textbf{Hosted file}

\verb`Table 3 Combined UAB and St.Jude Cohorts.docx`  available at \url{https://authorea.com/users/667687/articles/667816-association-of-elevated-tricuspid-regurgitation-velocity-with-cerebrovascular-and-kidney-disease-in-children-with-sickle-cell-disease}

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