{
  "abstract": "Cardiovascular complications are increasingly recognised as a major driver of morbidity and early mortality in patients with sickle cell disease (SCD), yet they remain underdiagnosed and underappreciated. This contemporary review synthesises current knowledge across a spectrum of cardiovascular manifestations—including myocardial dysfunction, pulmonary hypertension, cardiac iron overload, arrhythmias, myocardial infarction, stroke and sudden death—with emphasis on their unique pathophysiological mechanisms in SCD. We highlight emerging diagnostic tools such as cardiac magnetic resonance with T2* mapping and extracellular volume sequences, speckle-tracking echocardiography and invasive exercise testing, which can revealing a distinct phenotype combining restrictive cardiomyopathy and high-output heart failure. Practical algorithms for risk stratification and disease monitoring are presented alongside evidence-based and SCD-specific management approaches, including the role of hydroxyurea, transfusions, anticoagulation and gene therapy. By integrating multimodality imaging, updated guideline recommendations and recent clinical insights, this review provides a comprehensive resource to support early recognition, personalised therapy and improved cardiovascular outcomes in SCD.",
  "authors": [
    {
      "affiliations": [
        "Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA"
      ],
      "name": "Elio Haroun"
    },
    {
      "affiliations": [
        "Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA"
      ],
      "name": "Ankit Agrawal"
    },
    {
      "affiliations": [
        "Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA"
      ],
      "name": "Aro Daniela Arockiam"
    },
    {
      "affiliations": [
        "Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA"
      ],
      "name": "Joseph El Dahdah"
    },
    {
      "affiliations": [
        "Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA"
      ],
      "name": "Joseph Kassab"
    },
    {
      "affiliations": [
        "Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA"
      ],
      "name": "Michael Nakhla"
    },
    {
      "affiliations": [
        "Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA"
      ],
      "name": "Michel Chedid El Helou"
    },
    {
      "affiliations": [
        "Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA"
      ],
      "name": "Harsha Sanaka"
    },
    {
      "affiliations": [
        "Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA"
      ],
      "name": "Ziad Zalaquett"
    },
    {
      "affiliations": [
        "Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA"
      ],
      "name": "Simrat Kaur"
    },
    {
      "affiliations": [
        "Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA"
      ],
      "name": "Tiffany Dong"
    },
    {
      "affiliations": [
        "Department of Pediatric Hematology Oncology and Blood and Marrow Transplantation, Cleveland Clinic, Cleveland, Ohio, USA"
      ],
      "name": "Rabi Hanna"
    },
    {
      "affiliations": [
        "Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA"
      ],
      "name": "Brian Griffin"
    },
    {
      "affiliations": [
        "Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA"
      ],
      "name": "Tom Kai Ming Wang"
    }
  ],
  "title": "Cardiovascular disease in Sickle cell: mechanisms, diagnostics and therapeutic advances",
  "uid": "b92b5045-cc72-579a-b35d-e1ebb0c94ff7"
}