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Several score systems 1,2 have been developed in order to define the risk of death after transplantation. 3,4 The most commonly used is the Sorror index that includes cardiac function tests. Cardiac abnormalities are considered an independent prognostic factor in the standard pre-transplant procedures in most if not all centers. More specifically, ejection fraction is routinely evaluated using radionuclide ventriculography and/or echocardiography, which permits identification of those patients who have an ejection fraction lower than 50%. Since impaired systolic function is a relative contraindication for allogeneic hematopoietic cell transplantation (AlloHCT), some patients will be excluded from transplant program for this reason. However, the effect of cardiac dysfunction has been mainly investigated in studies using myeloablative conditioning and, moreover, the assessment of the cardiac function just based on the assessement of the ejection fraction based on ventriculography may be imprecise nowadays. 5In the current study we aimed to evaluate the prognostic value of echocardiographic features assessed within the pretransplant evaluation of patients undergoing AlloHCT.We retrospectively analyzed clinical records from patients consecutively undergoing AlloHCT in our institution from 2006 to 2014. Echocardiography was routinely performed in all transplant candidates as pre-transplant routine workup. Pre transplant demographic, diagnosis, previous treatments and laboratory data were collected for each patient. Transplant related data such as conditioning regimen, type of donor, hepatic and renal function were obtained as well as transplant overall outcomes.Pre-transplant echocardiography of each patient was performed by a certified cardiologist of our hospital. All measures were based in international standards outlined by the European College of Cardiologists. 6 In cases, where patients had more than one echocardiogram, the one closest to transplantation was analyzed. Echocardiographic aspects analysed were: left ventricular ejection fraction by the Teicholtz method as a surrogate marker of systolic function, trans-mitral flow velocity patterns with early peak flow velocity/atrial peak flow velocity (E/A ratio) as a surrogate marker of diastolic dysfunction, valvulopathy, arterial pulmonary pressure and pericardial effusion. We defined the presence of systolic dysfunction when ejection fraction was less than 50% and diastolic dysfunction if there was E/A ratio 42. In patients in whom echocardiographic abnormalities were found, clinical evaluation was performed by a cardiologist.The Shapiro-Wilk test was used to assess the normality of the quantitative variables. Demographic and baseline characteristics were summarized using as mean with percentages and ranges. Probabilities of overall survival (OS) were calculated using the Kaplan-Meier method, and unadjusted comparisons were made using the log-rank test, while relapse, non-relapse mortality (NRM) and graft versus host disease (GVHD) probabilities were analyzed...

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