Can We Perform the Maximal Treadmill Test on Individuals with Sickle Cell Disease?

Sickle cell disease (SCD) may present a stable clinical condition with the advancement of pharmacological treatment and available technologies for early diagnosis. However, if not diagnosed and treated early, it may lead to progressive organ damage and even fatal complications. Therefore, it is important to develop different instruments to assess the SCD prognosis. The maximal treadmill test (MTT), widely used in different diseases, such as heart failure, can play an important role in the risk stratification of these patients, since they usually have chest pain associated with vessel occlusion, causing myocardial ischemia and, consequently, sudden death, something very common in these individuals. ^,

However, patients with SCD need to exercise caution when performing physical exercises, especially at high-intensity, as these may lead to metabolic disorders that could favor erythrocyte sickling and promote vascular occlusions. This fact raised a discussion and a dilemma between recommending physical exercise for these patients or depriving them of the positive effects that physical exercise is capable of promoting. ^, Due to the association described above, between physical exercising and ischemia in SCD individuals, it is necessary to perform an exercise test. However, we get to the paradox of risk versus benefit. Can individuals with SCD safely perform a MTT to provide answers about the cardiovascular impact induced by exertion in the occurrence of clinical outcomes? This is what Araújo et al., Below we will describe the main study characteristics and its main results.

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