Echocardiography-Defined Pulmonary Hypertension in Multiple Myeloma: Risk Factors and Impact on Outcomes
| Autor: | Andrea Berger, H Lester Kirchner, Rahul Sangani, Matthew James Butler, Jason Stamm |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Hypertension Pulmonary medicine.medical_treatment Renal function Hematopoietic stem cell transplantation 030204 cardiovascular system & hematology Gastroenterology Cohort Studies 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine medicine Humans Heart Atria Renal Insufficiency Multiple myeloma Aged Retrospective Studies business.industry Age Factors Hematopoietic Stem Cell Transplantation Retrospective cohort study General Medicine medicine.disease Pulmonary hypertension Tricuspid Valve Insufficiency Surgery Echocardiography 030220 oncology & carcinogenesis Cohort Female Transthoracic echocardiogram Multiple Myeloma business Glomerular Filtration Rate Cohort study |
| Zdroj: | Southern Medical Journal. 109:282-289 |
| ISSN: | 0038-4348 |
| DOI: | 10.14423/smj.0000000000000461 |
| Popis: | Objectives Survival of patients with multiple myeloma (MM) has improved as a result of therapeutic advances. There is evidence that some patients with MM develop pulmonary hypertension (PH). The objective of this study was to identify risk factors of echocardiographic PH and its impact on outcomes of patients with MM. Methods We conducted a retrospective study of patients with MM (N = 359) diagnosed between 2000 and 2011 within the Geisinger Medical Center. Chart review was conducted on the subgroup of patients who underwent a transthoracic echocardiogram within 2 years of being diagnosed as having MM. Results A total of 34% of patients (N = 123/359) underwent transthoracic echocardiogram and 32% (N = 39/123) had echocardiography-defined PH. PH was significantly associated with older age (70.5 vs 65.3 years; P = 0.019), greater left atrial diameter (4.0 vs 3.7 cm; P = 0.025), and a trend toward decreased renal function. PH was not associated with myeloma-specific features. Fewer patients with PH underwent hematopoietic stem cell transplantation compared with those without PH (10% vs 30%; P = 0.018). There was no significant difference in survival between the PH and non-PH groups (P = 0.2775). Conclusions Echocardiography-defined PH was found in a sizeable minority of our MM cohort. Although the specific etiology of PH can be determined only through a prospective clinical evaluation, including right heart catheterization, our results suggest that PH in patients with MM is secondary to left heart disease and perhaps impaired renal function. Patients with PH were significantly less likely to undergo hematopoietic stem cell transplantation. Future studies should assess the etiology of PH, its impact on treatment decisions, and prognosis of patients with MM. |
| Databáze: | OpenAIRE |
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