{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T17:58:27Z","timestamp":1781632707762,"version":"3.54.5"},"reference-count":23,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>Sickle cell disease (SCD) is associated with substantial cardiovascular morbidity, but echocardiographic data from Latin American populations remain scarce. We aimed to characterise the structural, functional, and haemodynamic echocardiographic profile of adults with SCD attending a tertiary referral centre in Cali, Colombia. We conducted an observational, cross-sectional study based on systematic review of medical records and transthoracic echocardiography reports of consecutive adult patients (\u226518 years) with confirmed SCD evaluated between January 2022 and December 2024. Patients with complex congenital heart disease, severe valvular disease of unrelated aetiology, pregnancy, or echocardiograms of insufficient quality were excluded. Of 669 patients screened, 57 met inclusion criteria. Reporting followed STROBE recommendations. The median age was 24 years (interquartile range [IQR] 21\u201332) and 59.6% were female; the SS genotype was the most frequent (76.4%) and 68.5% were on hydroxyurea. Median haemoglobin was 8.5 g\/dL (IQR 7.1\u201310.0) and median NT-proBNP 491 pg\/mL (IQR 98\u20131290). Most patients had preserved left ventricular dimensions and systolic function (median ejection fraction 63%, IQR 57\u201366.5; mean global longitudinal strain \u221218.9%\u2009\u00b1\u20092.9). Right ventricular function was preserved (mean tricuspid annular plane systolic excursion 25.4\u2009\u00b1\u20094.6 mm). Left ventricular geometry was normal in 42.1%, with concentric remodelling in 10.5%, concentric hypertrophy in 21.1%, and eccentric hypertrophy in 26.3%. Diastolic function was normal in 71.4%. Valvular disease, when present, was predominantly mild. Tricuspid regurgitation velocity exceeded 2.5 m\/s in 14 of 36 patients with measurable TRV (38.9%; 24.6% of the whole cohort) and exceeded 3.0 m\/s in 6 patients (16.7% of those with measurable TRV), identifying a substantial subgroup at intermediate-to-high probability of pulmonary hypertension. In this Colombian cohort of relatively young adults with SCD, cardiac structure and biventricular function were largely preserved, but nearly one-third of patients had echocardiographic findings suggestive of pulmonary hypertension. These findings support the routine use of transthoracic echocardiography as an accessible tool for early cardiovascular risk stratification in adults with SCD in low- and middle-income settings.<\/jats:p>","DOI":"10.1371\/journal.pone.0348383","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T17:28:07Z","timestamp":1781630887000},"page":"e0348383","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Echocardiographic characterization and markers of cardiovascular risk in adults with sickle cell disease in a Colombian tertiary referral centre: A cross-sectional study"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1610-8465","authenticated-orcid":true,"given":"Martin E.","family":"Arrieta-Mendoza","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan R.","family":"Betancourt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebasti\u00e1n","family":"Ayala-Zapata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8701-5744","authenticated-orcid":true,"given":"Stephany","family":"Barbosa-Balaguera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian D.","family":"Messu-Llanos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan P.","family":"Rosales-Melo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dar\u00edo F.","family":"Andrade-Hoyos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1lvaro","family":"Herrera-Escand\u00f3n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oswaldo E.","family":"Aguilar-Molina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,6,16]]},"reference":[{"issue":"16","key":"pone.0348383.ref001","doi-asserted-by":"crossref","first-page":"1561","DOI":"10.1056\/NEJMra1510865","article-title":"Sickle cell disease","volume":"376","author":"FB Piel","year":"2017","journal-title":"N Engl J Med"},{"key":"pone.0348383.ref002","doi-asserted-by":"crossref","first-page":"18010","DOI":"10.1038\/nrdp.2018.10","article-title":"Sickle cell disease","volume":"4","author":"GJ Kato","year":"2018","journal-title":"Nat Rev Dis Primers"},{"issue":"8","key":"pone.0348383.ref003","article-title":"Global, regional, and national prevalence and mortality burden of sickle cell disease, 2000-2021: a systematic analysis from the Global Burden of Disease Study 2021","volume":"10","author":"GBD 2021 Sickle Cell Disease Collaborators","year":"2023","journal-title":"Lancet Haematol"},{"issue":"2","key":"pone.0348383.ref004","first-page":"111","article-title":"First two years of notification of orphan-rare diseases in Cali and identification of some variables associated with mortality","volume":"33","author":"J Ram\u00edrez-Cheyne","year":"2020","journal-title":"Iatreia"},{"issue":"1","key":"pone.0348383.ref005","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1002\/ajh.21569","article-title":"Cardiopulmonary complications leading to premature deaths in adult patients with sickle cell disease","volume":"85","author":"CD Fitzhugh","year":"2010","journal-title":"Am J Hematol"},{"issue":"13","key":"pone.0348383.ref006","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.1093\/eurheartj\/ehz217","article-title":"Cardiovascular manifestations of sickle cell disease","volume":"41","author":"N Hammoudi","year":"2020","journal-title":"Eur Heart J"},{"issue":"13","key":"pone.0348383.ref007","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1016\/j.jacc.2011.10.900","article-title":"Cardiovascular abnormalities in sickle cell disease","volume":"59","author":"MT Gladwin","year":"2012","journal-title":"J Am Coll Cardiol"},{"issue":"1","key":"pone.0348383.ref008","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1056\/NEJMoa1005565","article-title":"A hemodynamic study of pulmonary hypertension in sickle cell disease","volume":"365","author":"F Parent","year":"2011","journal-title":"N Engl J Med"},{"issue":"1","key":"pone.0348383.ref009","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1182\/asheducation-2017.1.423","article-title":"Cardiovascular complications in patients with sickle cell disease","volume":"2017","author":"MT Gladwin","year":"2017","journal-title":"Hematology Am Soc Hematol Educ Program"},{"issue":"4","key":"pone.0348383.ref010","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1016\/j.jacc.2006.09.038","article-title":"Diastolic dysfunction is an independent risk factor for death in patients with sickle cell disease","volume":"49","author":"V Sachdev","year":"2007","journal-title":"J Am Coll Cardiol"},{"issue":"4","key":"pone.0348383.ref011","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.jsha.2012.05.001","article-title":"Echocardiographic evaluation of left ventricular diastolic and systolic function in Saudi patients with sickle cell disease","volume":"24","author":"MF Abdul-Mohsen","year":"2012","journal-title":"J Saudi Heart Assoc"},{"issue":"3","key":"pone.0348383.ref012","doi-asserted-by":"crossref","first-page":"493","DOI":"10.5114\/aoms.2016.58785","article-title":"Left ventricular structural and functional changes evaluated by echocardiography and two-dimensional strain in patients with sickle cell disease","volume":"14","author":"R Bedirian","year":"2018","journal-title":"Arch Med Sci"},{"issue":"1","key":"pone.0348383.ref013","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1007\/s00277-009-0764-0","article-title":"Echocardiographic findings in patients with sickle cell disease","volume":"89","author":"SG Naoman","year":"2010","journal-title":"Ann Hematol"},{"issue":"9","key":"pone.0348383.ref014","doi-asserted-by":"crossref","first-page":"1271","DOI":"10.1111\/echo.14028","article-title":"Echocardiographic parameters to identify sickle cell patients with cardio-pathology","volume":"35","author":"S Chiadika","year":"2018","journal-title":"Echocardiography"},{"issue":"12","key":"pone.0348383.ref015","doi-asserted-by":"crossref","first-page":"1495","DOI":"10.1016\/j.ijsu.2014.07.013","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies","volume":"12","author":"E von Elm","year":"2014","journal-title":"Int J Surg"},{"issue":"1","key":"pone.0348383.ref016","article-title":"Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging","volume":"28","author":"RM Lang","year":"2015","journal-title":"J Am Soc Echocardiogr"},{"issue":"4","key":"pone.0348383.ref017","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/j.echo.2016.01.011","article-title":"Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging","volume":"29","author":"SF Nagueh","year":"2016","journal-title":"J Am Soc Echocardiogr"},{"issue":"38","key":"pone.0348383.ref018","doi-asserted-by":"crossref","first-page":"3618","DOI":"10.1093\/eurheartj\/ehac237","article-title":"2022 ESC\/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension","volume":"43","author":"M Humbert","year":"2022","journal-title":"Eur Heart J"},{"issue":"13","key":"pone.0348383.ref019","doi-asserted-by":"crossref","first-page":"1452","DOI":"10.1161\/CIRCULATIONAHA.111.032920","article-title":"Echocardiographic markers of elevated pulmonary pressure and left ventricular diastolic dysfunction are associated with exercise intolerance in adults and adolescents with homozygous sickle cell anemia in the United States and United Kingdom","volume":"124","author":"V Sachdev","year":"2011","journal-title":"Circulation"},{"issue":"3","key":"pone.0348383.ref020","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1056\/NEJMoa1715971","article-title":"A phase 3 trial of l-glutamine in sickle cell disease","volume":"379","author":"Y Niihara","year":"2018","journal-title":"N Engl J Med"},{"issue":"9","key":"pone.0348383.ref021","doi-asserted-by":"crossref","first-page":"886","DOI":"10.1056\/NEJMoa035477","article-title":"Pulmonary hypertension as a risk factor for death in patients with sickle cell disease","volume":"350","author":"MT Gladwin","year":"2004","journal-title":"N Engl J Med"},{"issue":"7","key":"pone.0348383.ref022","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1182\/blood-2015-08-618561","article-title":"Pathophysiology and treatment of pulmonary hypertension in sickle cell disease","volume":"127","author":"VR Gordeuk","year":"2016","journal-title":"Blood"},{"issue":"12","key":"pone.0348383.ref023","doi-asserted-by":"crossref","first-page":"1254","DOI":"10.1001\/jama.2012.358","article-title":"Mortality in adults with sickle cell disease and pulmonary hypertension","volume":"307","author":"A Mehari","year":"2012","journal-title":"JAMA"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0348383","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T17:28:11Z","timestamp":1781630891000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0348383"}},"subtitle":[],"editor":[{"given":"Philippe","family":"Connes","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,6,16]]},"references-count":23,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,6,16]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0348383","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,16]]}}}