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[Altered left ventricular diastolic function in patients with lymphogranulomatosis]
Insights
Hodgkin's disease impairs left heart ventricle function and diastolic blood flow, particularly with pericardial involvement or advanced tumor stages. Chemotherapy can worsen these cardiac diastolic disorders.
Area of Science:
- Cardiology
- Oncology
- Echocardiography
Context:
- Hodgkin's disease (HD) is a cancer of the lymphatic system.
- Cardiac complications can arise from HD, including tumor infiltration and treatment side effects.
- Diastolic dysfunction is a key indicator of cardiac health.
Purpose:
- To investigate the impact of Hodgkin's disease on left ventricular diastolic function and intracardiac hemodynamics using Doppler echocardiography.
- To assess the influence of tumor burden, specific HD variants, and chemotherapy on cardiac diastolic function.
Summary:
- Doppler echocardiography revealed impaired elastic characteristics and altered diastolic blood flow in the left ventricle of 28 HD patients.
- Pericardial involvement and advanced tumor intoxication (mixed-cell variant) correlated with more pronounced diastolic dysfunction, left atrial dysfunction, and left ventricular remodeling.
- Chemotherapy exacerbated diastolic blood flow disorders, with increased polychemotherapy courses linked to worsening left ventricular relaxation.
Impact:
- Tumor intoxication and chemotherapy cardiotoxicity are significant contributors to central hemodynamic disorders in HD patients.
- Diastolic dysfunction of the left heart ventricle is a principal component of these hemodynamic changes.
- Findings highlight the need for monitoring cardiac function in HD patients, considering both disease progression and treatment effects.
Abstract:
Impaired elastic characteristics of the left heart ventricle and restructuring of its diastolic bloodflow were revealed in 28 patients with Hodgkin's disease by complex Doppler echocardiographic study of intracardiac hemodynamics. The most pronounced disorders of the diastolic function were detected in patients with pericardial involvement. More pronounced tumor intoxication in patients with mixed-cell variant of the tumor resulted in remodeling of the left ventricle, left atrial dysfunction, and restructuring of the diastolic bloodflow, which indicated combined impairment of the left ventricular diastolic relaxation and left atrial contractility. Chemotherapy augmented disorders in diastolic bloodflow, the increase in the number of polychemotherapy courses being associated with a trend to deterioration of left-ventricular relaxation. Hence, tumor intoxication and drug cardiotoxicity determine the formation of central hemodynamic disorders, one of whose principal components is diastolic dysfunction of the left heart ventricle.