Biventricular Dysfunction in Patients After Bone Marrow Transplant

Deshmukh, T.; Geenty, P.; Geraghty, L.; Emmerig, David; Sivapathan, S.; Hogg, Megan; Brown, P.; Panicker, Shyam; Altman, M.; Gottlieb, David; Thomas, Liza

doi:10.1016/j.jaccao.2019.11.008

Cited by 2 publications

(2 citation statements)

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“…Similarly, for OS, high levels of serum ferritin were significantly associated with poor outcomes [ 12 ], but the same was not true for GLS. Anthracycline is widely used to treat hematologic malignancies and is known to cause chemotherapy‐related cardiac dysfunction (CTRCD) [ 13 , 14 ]. In our study, patients who had received ≥200 anthracycline had a tendency to develop more cardiac events ( p = 0.06).…”

Section: Discussionmentioning

confidence: 99%

“…Several studies on GLS in allogeneic HSCT recipients have been reported [ 14 , 15 ]; however, much remains to be elucidated regarding long‐term cardiac follow‐up with GLS. Recent studies have shown that GLS is a more sensitive parameter than EF for evaluating cardiac function in patients with heart failure or CTRCD [ 6 , 7 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

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Global longitudinal strain is superior to ejection fraction for long‐term follow‐up after allogeneic hematopoietic stem cell transplantation

Watanabe

Yakushijin

Tanaka

et al. 2022

eJHaem

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Global longitudinal strain (GLS), a new cardiac parameter measured by the speckletracking method, is reportedly more sensitive than ejection fraction (EF) in detecting slight cardiac dysfunction in heart failure patients. We validated the utility of GLS in allogeneic hematopoietic stem cell transplantation (HSCT) patients during a long-term follow-up. Medical records of patients who underwent allogeneic HSCT between 2013 and 2020 were reviewed retrospectively. We evaluated the last echocardiography performed before transplantation and those performed annually during the 5 years after transplantation. We also investigated newly diagnosed cardiac events, which developed after HSCT. Among 85 patients, 22 used cardioprotective drugs. The median follow-up duration in surviving patients was 54.1 months (range, 2.9-92.6 months).GLS significantly decreased year by year, and patients taking cardioprotective agents tended to have a better GLS at 5 years than at 3 years, while EF did not change. Fifteen patients developed newly diagnosed cardiac events. Multivariate analysis revealed that low GLS and high serum ferritin levels at baseline were independently associated with the development of cardiac events. Therefore, we need a continuous followup of cardiac function by GLS and prescription of cardioprotective drugs might be considered for HSCT patients with low GLS. Further research is warranted.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Global longitudinal strain is superior to ejection fraction for long‐term follow‐up after allogeneic hematopoietic stem cell transplantation

Watanabe

Yakushijin

Tanaka

et al. 2022

eJHaem

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The utility of strain imaging in the cardiac surveillance of bone marrow transplant patients

Deshmukh

Emerson

Geenty

et al. 2021

Heart

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ObjectiveTo evaluate the utility of two-dimensional multiplanar speckle tracking strain to assess for cardiotoxicity post allogenic bone marrow transplantation (BMT) for haematological conditions.MethodsCross-sectional study of 120 consecutive patients post-BMT (80 pretreated with anthracyclines (BMT+AC), 40 BMT alone) recruited from a late effects haematology clinic, compared with 80 healthy controls, as part of a long-term cardiotoxicity surveillance study (mean duration from BMT to transthoracic echocardiogram 6±6 years). Left ventricular global longitudinal strain (LV GLS), global circumferential strain (LV GCS) and right ventricular free wall strain (RV FWS) were compared with traditionl parameters of function including LV ejection fraction (LVEF) and RV fractional area change.ResultsLV GLS (−17.7±3.0% vs −20.2±1.9%), LV GCS (−14.7±3.5% vs −20.4±2.1%) and RV FWS (−22.6±4.7% vs −28.0±3.8%) were all significantly (p=0.001) reduced in BMT+AC versus controls, while only LV GCS (−15.9±3.5% vs −20.4±2.1%) and RV FWS (−23.9±3.5% vs −28.0±3.8%) were significantly (p=0.001) reduced in BMT group versus controls. Even in patients with LVEF >53%, ~75% of patients in both BMT groups demonstrated a reduction in GCS.ConclusionMultiplanar strain identifies a greater number of BMT patients with subclinical LV dysfunction rather than by GLS alone, and should be evaluated as part of post-BMT patient surveillence. Reduction in GCS is possibly due to effects of preconditioning, and is not fully explained by AC exposure.

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Biventricular Dysfunction in Patients After Bone Marrow Transplant

Cited by 2 publications

References 10 publications

Global longitudinal strain is superior to ejection fraction for long‐term follow‐up after allogeneic hematopoietic stem cell transplantation

Global longitudinal strain is superior to ejection fraction for long‐term follow‐up after allogeneic hematopoietic stem cell transplantation

The utility of strain imaging in the cardiac surveillance of bone marrow transplant patients

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