Subtle cardiac dysfunction in lymphoma patients receiving low to moderate dose chemotherapy

• Published in: Scientific reports Vol. 11; no. 1; p. 7100
• Main Authors: Chang, Hsien-Yuan, Lee, Chun-Hui, Su, Po-Lan, Li, Sin-Syue, Chen, Ming-Yueh, Chen, Ya-Ping, Hsu, Ya-Ting, Tsai, Wei-Chuan, Liu, Ping-Yen, Chen, Tsai-Yun, Liu, Yen-Wen
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 29.03.2021; Nature Publishing Group; Nature Portfolio
• Subjects: 631/67/1990/291; 692/4019; Cancer therapies; Chemotherapy; Congestive heart failure; Humanities and Social Sciences; Lymphoma; multidisciplinary; Oxygen consumption; Science; Science (multidisciplinary); Ventricle
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-021-86652-x

Left ventricular (LV) global peak systolic longitudinal strain (GLS) is a sensitive measurement for detecting subtle LV systolic dysfunction and a powerful prognostic predictor. However, the clinical implication of LV GLS in lymphoma patients receiving cancer therapy remains unknown. We prospectively enrolled 74 lymphoma patients (57.9 ± 17.0 years old, 57% male). We performed echocardiographic studies after the 3rd and 6th cycles and 1 year after chemotherapy and a cardiopulmonary exercise test upon completion of 3 cycles of anticancer therapy. Cancer therapy-related cardiac dysfunction (CTRCD) was defined as a ≥ 15% relative reduction in GLS value from baseline. The primary outcome was a composite of all-cause mortality and heart failure events. Thirty-six patients (49%) had CTRCD (LV GLS: baseline vs. after 3rd cycle of therapy: 20.1 ± 2.6 vs. 17.5 ± 2.3%, p  < 0.001). CTRCD was detected after the 3rd cycle of anticancer therapy. CTRCD patients had impaired exercise capacity (minute oxygen consumption/kg, CTRCD vs. CTRCD (-): 13.9 ± 3.1 vs. 17.0 ± 3.9 ml/kg/min, p  = 0.02). More primary outcome events occurred in the CTRCD group (hazard ratio 3.21; 95% confidence interval 1.04–9.97; p  = 0.03). LV GLS could detect subtle but clinically significant cardiac dysfunction in lymphoma patients in the early stage of anticancer therapy. CTRCD may be associated with not only a reduced exercise capacity but also a worse prognosis.