Baseline Global Longitudinal Strain as a Predictor of Left Ventricular Dysfunction and Hospitalization for Heart Failure of Patients With Malignant Lymphoma After Anthracycline Therapy
| Autor: | Hiroyuki Sano, Yasuhide Mochizuki, Hiroki Takada, Kensuke Matsumoto, Hidekazu Tanaka, Akiko Nonaka, Junichi Ooka, Fumitaka Soga, Yutaka Hatani, Hiroki Matsuzoe, Keiko Hatazawa, Ken-ichi Hirata, Hiroyuki Shimoura |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Anthracycline Longitudinal strain Lymphoma medicine.medical_treatment Heart failure Disease Kaplan-Meier Estimate 030204 cardiovascular system & hematology Logistic regression 03 medical and health sciences Ventricular Dysfunction Left 0302 clinical medicine Predictive Value of Tests Internal medicine medicine Humans Anthracyclines Ventricular function Aged Speckle tracking Chemotherapy Ejection fraction business.industry Cancer Stroke Volume General Medicine Middle Aged medicine.disease Hospitalization ROC Curve Echocardiography 030220 oncology & carcinogenesis Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Circulation Journal. 82(10):2566-2574 |
| ISSN: | 1346-9843 |
| Popis: | Background Our aim was to investigate the baseline clinical and echocardiographic parameters for predicting left ventricular (LV) dysfunction after anthracycline chemotherapy and heart failure (HF) hospitalization in a single cancer disease. Methods and Results: We studied 73 patients with malignant lymphoma and preserved LV ejection fraction (LVEF). Echocardiography was performed before and after anthracycline chemotherapy. Global longitudinal strain (GLS) was determined from 3 standard apical views. LV dysfunction after anthracycline chemotherapy was defined according to the current definition of cancer therapeutics-related cardiac dysfunction. Long-term (50-month) unfavorable outcome was prespecified as hospitalization for HF. A total of 10 patients had LV dysfunction after anthracycline chemotherapy. Multivariate logistic regression analysis showed that baseline GLS was the only independent predictor of this dysfunction. Receiver-operating characteristic curve analysis identified the optimal GLS cutoff for predicting LV dysfunction after anthracycline chemotherapy as ≤19% (P=0.008). Furthermore, the Kaplan-Meier curve indicated that fewer patients with GLS >19% were hospitalized for HF than among those with GLS ≤19% (log-rank P=0.02). For sequential logistic models, a model based on baseline clinical variables (χ2=2.9) was improved by the addition of baseline LVEF (χ2=9.0; P=0.01), and further improved by the addition of baseline GLS (χ2=13.1, P=0.04). Conclusions Watchful observation or early therapeutic intervention with established cardioprotective medications may be necessary for patients with malignant lymphoma and preserved LVEF but with abnormal GLS. |
| Databáze: | OpenAIRE |
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