Abstract

Left ventricular (LV) global peak systolic longitudinal strain (GLS) is a sensitive measurement for detecting subtle LV systolic dysfunction and a powerful prognostic predictor. However, the clinical implication of LV GLS in lymphoma patients receiving cancer therapy remains unknown. We prospectively enrolled 74 lymphoma patients (57.9 ± 17.0 years old, 57% male). We performed echocardiographic studies after the 3rd and 6th cycles and 1 year after chemotherapy and a cardiopulmonary exercise test upon completion of 3 cycles of anticancer therapy. Cancer therapy-related cardiac dysfunction (CTRCD) was defined as a ≥ 15% relative reduction in GLS value from baseline. The primary outcome was a composite of all-cause mortality and heart failure events. Thirty-six patients (49%) had CTRCD (LV GLS: baseline vs. after 3rd cycle of therapy: 20.1 ± 2.6 vs. 17.5 ± 2.3%, p < 0.001). CTRCD was detected after the 3rd cycle of anticancer therapy. CTRCD patients had impaired exercise capacity (minute oxygen consumption/kg, CTRCD vs. CTRCD (-): 13.9 ± 3.1 vs. 17.0 ± 3.9 ml/kg/min, p = 0.02). More primary outcome events occurred in the CTRCD group (hazard ratio 3.21; 95% confidence interval 1.04–9.97; p = 0.03). LV GLS could detect subtle but clinically significant cardiac dysfunction in lymphoma patients in the early stage of anticancer therapy. CTRCD may be associated with not only a reduced exercise capacity but also a worse prognosis.

Details

Title
Subtle cardiac dysfunction in lymphoma patients receiving low to moderate dose chemotherapy
Author
Hsien-Yuan, Chang 1 ; Chun-Hui, Lee 2 ; Po-Lan, Su 3 ; Li Sin-Syue 2 ; Ming-Yueh, Chen 4 ; Chen, Ya-Ping 4 ; Ya-Ting, Hsu 4 ; Wei-Chuan, Tsai 5 ; Ping-Yen, Liu 1 ; Tsai-Yun, Chen 4 ; Yen-Wen, Liu 1 

 National Cheng Kung University, Institute of Clinical Medicine, College of Medicine, Tainan, Taiwan (GRID:grid.64523.36) (ISNI:0000 0004 0532 3255); National Cheng Kung University, Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, Tainan, Taiwan (GRID:grid.64523.36) (ISNI:0000 0004 0532 3255) 
 National Cheng Kung University, Institute of Clinical Medicine, College of Medicine, Tainan, Taiwan (GRID:grid.64523.36) (ISNI:0000 0004 0532 3255); National Cheng Kung University, Division of Hematology and Oncology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, Tainan, Taiwan (GRID:grid.64523.36) (ISNI:0000 0004 0532 3255) 
 National Cheng Kung University, Division of Chest, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, Tainan, Taiwan (GRID:grid.64523.36) (ISNI:0000 0004 0532 3255) 
 National Cheng Kung University, Division of Hematology and Oncology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, Tainan, Taiwan (GRID:grid.64523.36) (ISNI:0000 0004 0532 3255) 
 National Cheng Kung University, Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, Tainan, Taiwan (GRID:grid.64523.36) (ISNI:0000 0004 0532 3255) 
Publication year
2021
Publication date
2021
Publisher
Nature Publishing Group
e-ISSN
20452322
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2506711122
Copyright
© The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.