Left ventricular filling pressure in sickle cell anemia

Indirect left ventricular filling pressures were measured via balloon-tipped catheters in 11 studies of 10 patients with sickle cell anemia and cardiorespiratory symptomatology. Pulmonary capillary wedge pressures exceeded 12 mm Hg in 8 of 11 studies (8 of 10 patients). Mean pressures in mm Hg were: pulmonary capillary wedge, 16.5 +/- 4.2 (SEM); pulmonary artery, 38 +/- 16; brachial artery, 104 +/- 128; and right atrium, 11 +/- 4. The mean cardiac output was 8.8 +/- 3.1 L/min. The mean pulmonary vascular resistance was 237 +/- 122 dynes sec cm-5 and was significantly increased in 4 patients. In addition to further documentation of significantly elevated pulmonary artery pressures in sickle cell anemia patients with cardiopulmonary symptomatology, these data indicate that a contributory role for elevated left ventricular filling pressures must be considered in the pathogenesis of pulmonary hypertension in sickle cell anemia. Elevation of the pulmonary artery pressure was usually associated with elevation of the pulmonary capillary wedge pressure.