Risk factors affecting cardiac left-ventricular hypertrophy and systolic and diastolic function in the chronic phase of allogeneic hematopoietic cell transplantation

Abstract

Chronic impairment of cardiac function can be an important health risk and impair the quality of life, and may even be life-threatening for long-term survivors of allogeneic hematopoietic cell transplantation (HCT). However, risk factors for and/or the underlying mechanism of cardiac dysfunction in the chronic phase of HCT are still not fully understood. We retrospectively investigated factors affecting cardiac function and left-ventricular hypertrophy (LVH) in the chronic phase of HCT. Sixty-three recipients who survived for 41 year after receiving HCT were evaluated using echocardiography. Based on simple linear regression models, high-dose TBI-based conditioning was significantly associated with a decrease in left-ventricular ejection fraction and the early peak flow velocity/atrial peak flow velocity ratio, following HCT (coefficient ¼ À 5.550, P ¼ 0.02 and coefficient ¼ À 0.268, P ¼ 0.02, respectively). These associations remained significant with the use of multiple linear regression models. Additionally, the serum ferritin (s-ferritin) level before HCT was found to be a significant risk factor for LVH on multivariable logistic analysis (P ¼ 0.03). In conclusion, our study demonstrated that a myeloablative regimen, especially one that involved high-dose TBI, impaired cardiac function, and that a high s-ferritin level might be associated with the development of LVH in the chronic phase of HCT.

Séquelles post-allogreffe de cellules souches hématopoïétiques

“…Parmi les patients qui avaient des complications cardiaques, tous ont reçu une ICT. Les principaux facteurs de risque sont les antécédents d'administration d'anthracyclines et de cyclophosphamide, d'irradiation du myocarde, de syndrome métabolique, d'hémochromatose ou un terrain de drépanocy-tose [25]. La SFGM-TC au cours des 4 es ateliers d'harmonisation des pratiques a recommandé que le suivi soit assuré à partir de 1 an post-greffe par la réalisation d'une échographie cardiaque tous les 2 ans jusqu'à la fin de la croissance puis tous les 4 à 5 ans à vie et si grossesse ou activité sportive intensive [1].…”

Cardiovascular disease following hematopoietic stem cell transplantation: Pathogenesis, detection, and the cardioprotective role of aerobic training

“…36 Radiation and/or chemotherapy causes direct cardiovascular injury contributing to the manifestation of two distinct but related forms of CVD morbidity and mortality: cardiomyopathy associated with HF, and CAD. 37 …”

Prise en charge des séquelles après greffe de cellules souches hématopoïétiques chez l’enfant : recommandations de la SFGM-TC

“…Coeur [28][29][30] Nature des troubles : insuffisance cardiaque congestive, coronaropathie, troubles du rythme, valvulopathie, accidents vasculaires cé ré braux. .…”