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41 INNOSC Theranostics and Pharmacological Sciences, 2023, Vol. 6, No. 1 Hariharan

Figure 2. Forest plot showing the prevalence of pulmonary hypertension among sickle cell anemia
children and adolescents (n = 31).

heterogeneity was found among the included SCA patients as the risk of PHT is similar across
studies. Hence, meta-regression was performed and the groups. In addition, we found the burden of
found that quality of evidence, mean age, and study PHT in SCA patients to be higher than those in
design are potential source of heterogeneity in this general population or special groups suh as AIDS
review. The presence of publication bias indicated patients and systemic sclerosis patients [50,51,53].
by asymmetrical funnel plot was also found. However, it was significantly lower compared
The prevalence of PHT among children and to patients with cardiac, respiratory, or renal
adolescents with SCA was 22% (95% CI: 18 – comorbid conditions [51,52]. However, most of the
26%). The previous reviews on PHT focused studies included in the current review and previous
primarily on the participants with SCA irrespective reviews have used TRV to determine the burden
of their age group or general population or special of PHT. This tends to overestimate the prevalence
groups such as acquired immunodeficiency as the definition of PHT with echocardiography is
syndrome (AIDS) patients, end-stage renal disease still a matter of continuous debate. This is because
patients, and systemic sclerosis patients [49-53]. TRV of 2.5 m/s reflects a right ventricular systolic
Our findings were almost similar to the previous pressure of 27 mmHg plus right atrial pressure, a
review reporting the prevalence of PHT among pressure far from being relevant for pulmonary
adult SCA patients [49]. This indicates that there vasculopathy. Hence, it is mandatory to use cardiac
is not much variation in the burden of PHT among catheterization when defining PHT, and the future
SCA patients, irrespective of their age group. studies should focus on doing it to establish
Hence, equal importance should be given to all the the burden of PHT. Still, the findings from this

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