Peripheral arterial tonometry in assessing endothelial dysfunction in pediatric sickle cell disease.

ABSTRACT

BACKGROUND: SCD is characterized by hemolysis and oxidative stress, resulting in endothelial dysfunction (EDF). Peripheral arterial tonometry (PAT), a noninvasive technology for measuring EDF, utilizes reactive hyperemia following mini-ischemic stress (reactive hyperemia index or RHI). METHODS: The authors studied PAT in 36 SCD children to determine the influence of hemoglobin genotype and treatment on EDF. RESULTS AND CONCLUSIONS: Blunted RHI was seen in the majority of children with SCD, especially with increased symptomatology (1.53 and 1.71; p value .032). RHI was not normal in children on chronic transfusion or hydroxyurea. RHI correlated with reticulocyte fraction (Spearman r = -.47, p = .037). PAT merits further exploration as a measure of EDF in SCD.