Serial Changes in Cardiac Strain and Contractility After Hematopoietic Stem Cell Transplantation in Patients with Hematologic Malignancies

Oka, Tôru; Tada, Yasuyuki; Oboshi, Makiko; Kamada, Risa; Yasui, Toshihiro; Shioyama, Wataru; Nishikawa, Tatsuya; Hino, Akihisa; Ishikawa, Jun; Fujita, Masashi

doi:10.1536/ihj.20-434

Cited by 3 publications

(2 citation statements)

References 27 publications

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“…Interesting data were obtained by Oka et al, who examined serial changes in cardiac strain and contractility in patients with hematologic malignancies after hematopoietic stem cell transplantation (HSCT). They found that GLS before HSCT might be associated with a decrease in LVEF after HSCT [32]. The results from a study on patients with colorectal cancer confirmed the usefulness of GLS in the diagnosis of bevacizumab-induced cardiotoxicity [33].…”

Section: The Use Of Gls Assessment In Patients With Various Cancersmentioning

confidence: 77%

Global Longitudinal Strain in Cardio-Oncology: A Review

Sławiński

Hawryszko

Liżewska-Springer

et al. 2023

Cancers

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Several therapies used in cancer treatment are potentially cardiotoxic and may cause left ventricular (LV) dysfunction and heart failure. For decades, echocardiography has been the main modality for cardiac assessment in cancer patients, and the parameter examined in the context of cardiotoxicity was the left ventricular ejection fraction (LVEF). The assessment of the global longitudinal strain (GLS) using speckle tracking echocardiography (STE) is an emerging method for detecting and quantifying subtle disturbances in the global long-axis LV systolic function. In the latest ESC guidelines on cardio-oncology, GLS is an important element in diagnosing the cardiotoxicity of oncological therapy. A relative decrease in GLS of >15% during cancer treatment is the recommended cut-off point for suspecting subclinical cardiac dysfunction. An early diagnosis of asymptomatic cardiotoxicity allows the initiation of a cardioprotective treatment and reduces the risk of interruptions or changes in the oncological treatment in the event of LVEF deterioration, which may affect survival.

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Section: The Use Of Gls Assessment In Patients With Various Cancersmentioning

confidence: 77%

Global Longitudinal Strain in Cardio-Oncology: A Review

Sławiński

Hawryszko

Liżewska-Springer

et al. 2023

Cancers

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“…Subtle deterioration in LV systolic function may be better detected by the global longitudinal strain method. 31 Second, this was a single-centre retrospective study with a limited number of patients, and patients without echocardiography before or after HSCT were excluded. As echocardiography was performed at a physician's discretion, participant enrolment may have potentially led to a selection bias.…”

Section: Limitationsmentioning

confidence: 99%

Early-onset cardiac dysfunction following allogeneic haematopoietic stem cell transplantation

et al. 2022

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ObjectiveHeart failure following allogeneic haematopoietic stem cell transplantation (allo-HSCT) is a serious complication that requires early detection; however, the clinical implications of early-onset cancer therapy-related cardiac dysfunction (CTRCD) following allo-HSCT remain unclear. We investigated the determinants and prognostic impact of early-onset CTRCD in allo-HSCT recipients.MethodsThe records of 136 patients with haematological malignancies who underwent allo-HSCT at our institute were retrospectively reviewed. Early-onset CTRCD was defined as a decrease in left ventricular ejection fraction (LVEF) of ≥10% and an LVEF of ≤53% within 100 days after HSCT.ResultsEarly-onset CTRCD was diagnosed in 23 out of 136 included patients (17%), and the median duration from HSCT to CTRCD diagnosis was 24 (9–35) days. Patients were followed up for 347 (132–1268) days. In multivariate logistic regression analysis, cumulative doxorubicin dosage (each 10 mg/m2) and severity of acute graft-versus-host disease (GVHD/grade) were independent indicators of early-onset CTRCD (OR (95% CI) 1.04 (1.00 to 1.07); p=0.032; OR (95% CI) 1.87 (1.19 to 2.95), p=0.004, respectively). The overall and primary disease death rates were significantly higher in allo-HSCT recipients with early-onset CTRCD than in those without early-onset CTRCD (HR (95% CI) 1.98 (1.11 to 3.52), p=0.016; HR (95% CI) 2.96 (1.40 to 6.29), p=0.005, respectively), independent of primary disease type, remission status and transplantation type.ConclusionsSevere acute GVHD and higher cumulative anthracycline are two significant determinants of early-onset CTRCD. Early-onset CTRCD following allo-HSCT regulates survival in patients with haematological malignancies.

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Cardiac function in long-term survivors of children posthematopoietic stem cells transplantation

Sayed,

Mohamed,

Elzoghby

et al. 2024

Egypt J Haematol

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Introduction Hematopoietic stem cell transplantation (HSCT) is a potentially curative treatment for many refractory malignancies, bone marrow failure syndromes, and primary immune deficiencies. Despite the significant improvement in survival after HSCT, the therapy is associated with major short and long-term morbidity and mortality. Cardiovascular complications are increasingly recognized as potential outcomes following HSCT. Echocardiography is the method of choice for detecting myocardial dysfunction before, during, and after chemotherapy. Cardiotoxicity was defined as a decrease in left ventricle ejection fraction (LVEF) more than 10% from the baseline cardiac function or ejection fraction ≤50%. Methods This cross-sectional study was conducted at the pediatric transplantation and cardiology units at Ain Shams University, Cairo, Egypt. Twenty-two long-term survival children underwent hematopoietic stem cells transplantation from 2011 to 2019. Full medical history and examination data were collected. Conventional and two-dimensional (2D) speckle tracking echo were done. Results The mean age of patients at the time of study was 12.95 ± 4.82 years. Mean age at the time of transplant was 7.02 ± 3.84 years. They were 50% males & 50% females. Long-term survival mean duration was six years. About eighty-six percent of the patients had nonmalignant diseases, while 13% patients had malignant diseases. Regarding the conditioning regimen used; 41% received Cy/ATG, 50% received Cy/Bu and 9% received BEAM. Twenty percent of patients developed acute GVHDs (grade I to II), while 22.7% patients developed chronic GVHDs included 13.7% patients limited skin and ocular manifestations, while 9% had extensive chronic GVHDs. Echocardiography showed that all patients had normal systolic and diastolic function. Only one patient (4.5%) had borderline left ventricle dilatation by M mode, while two patients (9%) had abnormal global longitudinal strain (GLS) by 2D speckle tracking. One had a GLS of 16% and the other one had mild hypokinesia with a GLS of 14%. There was no significant difference between studied patients with cardiac affection and those without cardiac affection as regards demographic data, conditioning regimens, GVHDs prophylaxis and complications of transplant (P value > 0.05). Conclusion Monitoring of cardiac function by 2D speckle tracking echo is important to detect any subtle cardiac affection in long-term survivors of HSCT.

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Serial Changes in Cardiac Strain and Contractility After Hematopoietic Stem Cell Transplantation in Patients with Hematologic Malignancies

Cited by 3 publications

References 27 publications

Global Longitudinal Strain in Cardio-Oncology: A Review

Global Longitudinal Strain in Cardio-Oncology: A Review

Early-onset cardiac dysfunction following allogeneic haematopoietic stem cell transplantation

Cardiac function in long-term survivors of children posthematopoietic stem cells transplantation

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