Left ventricular mechanics in patients with hematological malignancies before initiation of chemo- and radiotherapy.
Milan PavlovicAleksandar DordevicSabine HaßfeldCesare CuspidiHans-Dirk DüngenMarijana TadicPublished in: The international journal of cardiovascular imaging (2020)
Objective We sought to investigate left ventricular (LV) structure, function and mechanics in the patients with leukemia and lymphoma before initiation of chemotherapy, as well as the relationship between hematological malignancies and reduced LV longitudinal strain. Methods This retrospective investigation included 71 patients with leukemia and lymphoma before chemotherapy and 36 healthy controls. All participants underwent echocardiographic examination before initiation of chemotherapy and radiotherapy. Results LV global longitudinal strain (- 20.2 ± 1.7% vs. - 17.9 ± 3.0%, p < 0.001) was significantly lower in the patients with hematological malignancies than in controls. There was no difference in LV circumferential and radial strains between two observed groups. Subendocardial and subepicardial longitudinal strains were significantly lower in the patients with hematological malignancies (- 20.5 ± 3.6% vs. - 22.5 ± 3.8%, p = 0.001 for subendocardial strain; - 18.0 ± 1.5% vs. - 15.8 ± 2.6%, p < 0.001 for subepicardial strain). Hematological malignancies were associated with reduced global LV longitudinal strain (OR 21.0; 95%CI 2.04-215.0, p = 0.010) independently of age, gender, heart rate, body mass index, left ventricular ejection fraction, left ventricular mass index, and glucose level. Conclusions LV longitudinal strain was impaired in the patients with leukemia and lymphoma even before initiation of chemotherapy. Endocardial and epicardial LV layers are equally affected in the patients with hematological malignancies. Newly diagnosed hematological malignancies were related with reduced LV global longitudinal strain independently of common clinical and echocardiographic parameters.
Keyphrases
- left ventricular
- locally advanced
- ejection fraction
- aortic stenosis
- cross sectional
- heart rate
- heart failure
- mitral valve
- body mass index
- cardiac resynchronization therapy
- left atrial
- acute myeloid leukemia
- acute myocardial infarction
- hypertrophic cardiomyopathy
- newly diagnosed
- early stage
- diffuse large b cell lymphoma
- escherichia coli
- bone marrow
- squamous cell carcinoma
- rectal cancer
- radiation therapy
- pulmonary hypertension
- heart rate variability
- physical activity
- skeletal muscle
- chemotherapy induced
- mental health
- aortic valve
- metabolic syndrome
- drug induced
- percutaneous coronary intervention
- weight gain
- combination therapy
- solar cells
- catheter ablation