3D echocardiography, arterial stiffness, and biomarkers in early diagnosis and prediction of CHOP-induced cardiotoxicity in non-Hodgkin’s lymphoma

Autor: Natalia Patrascu, Diana Mihalcea, Dragos Vinereanu, Ramona Bruja, Maria Florescu, Ana-Maria Vladareanu
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
medicine.medical_treatment
Echocardiography
Three-Dimensional
lcsh:Medicine
030204 cardiovascular system & hematology
CHOP
Ventricular Dysfunction
Left
0302 clinical medicine
Antineoplastic Combined Chemotherapy Protocols
Prospective Studies
lcsh:Science
Multidisciplinary
Lymphoma
Non-Hodgkin
Middle Aged
Oncology
Vincristine
030220 oncology & carcinogenesis
Cardiology
cardiovascular system
Female
Cardiomyopathies
medicine.drug
circulatory and respiratory physiology
Adult
medicine.medical_specialty
Cyclophosphamide
Sensitivity and Specificity
Article
03 medical and health sciences
Imaging
Three-Dimensional
Vascular Stiffness
Predictive Value of Tests
Internal medicine
medicine
Biomarkers
Tumor
Humans
Chemotherapy
Doxorubicin
cardiovascular diseases
Aged
Cardiotoxicity
business.industry
Myocardium
lcsh:R
Reproducibility of Results
medicine.disease
Non-Hodgkin's lymphoma
Arterial stiffness
Prednisone
lcsh:Q
business
Zdroj: Scientific Reports, Vol 10, Iss 1, Pp 1-11 (2020)
Scientific Reports
ISSN: 2045-2322
DOI: 10.1038/s41598-020-75043-3
Popis: CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) represents standard chemotherapy in non-Hodgkin's lymphoma (NHL) with risk of cardiotoxicity. To define new parameters, such as 3D myocardial deformation, arterial stiffness, and biomarkers for early diagnosis and prediction of cardiotoxicity. 110 NHL patients with LVEF > 50%, scheduled for CHOP, were evaluated at baseline, after third cycle and chemotherapy completion. 3DE assessed LVEF and myocardial deformation: longitudinal (LS), radial, circumferential, area strain. Echo-tracking analysed arterial stiffness: PWV, β index, wave intensity. Troponin I and NT-pro-BNP were measured. After chemotherapy completion, 18 patients (16%) (group I) developed cardiotoxicity (LVEF decrease 10% from baseline); 92 patients (group II) did not. Significant reduction of 3D LV deformation and increase of arterial stiffness developed starting with third cycle, with greater changes in group I. LS reduction and PWV increase after third cycle were the best independent predictors for LVEF decrease; the association of LS decrease by > 19% and PWV increase by > 27% after third cycle predicted cardiotoxicity after chemotherapy completion (90% sensitivity and 81% specificity). 3D LS and PWV can detect early chemotherapy-induced cardiotoxicity and predict LVEF decline. These parameters should be incorporated in clinical protocols to monitor cardiovascular function during chemotherapy and early intervention.
Databáze: OpenAIRE
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