Effect of bone marrow transplantation on diastolic function indices
Mersedeh Karvandi1, Mohammad Asadpour Piranfar, Shahrooz Yazdani
1Taleghani Hospital, Shahid Beheshti University of Medical Sciences Tehran, Iran.
Insights
Bone marrow transplantation (BMT) significantly impairs cardiac diastolic function, leading to decreased E-wave velocity and prolonged relaxation times. These findings highlight potential cardiac complications following BMT procedures.
Area of Science:
- Cardiology
- Oncology
- Transplantation Medicine
Background:
- High-dose chemotherapy and bone marrow transplantation (BMT) can adversely affect cardiac function.
- While chemotherapy's impact on diastolic function is known, BMT's effects are less understood.
- This study investigates cardiac diastolic function changes post-BMT.
Purpose of the Study:
- To evaluate alterations in cardiac diastolic function before and after autologous bone marrow transplantation (BMT).
- To assess the impact of BMT on left ventricular and right ventricular diastolic parameters.
Main Methods:
- Prospective study involving patients undergoing autologous BMT for lymphoma, multiple myeloma, or solid tumors.
- Cardiac consultation and tissue Doppler echocardiography were performed pre- and post-BMT.
- Measured parameters included E-wave velocity and time to relaxation in multiple left ventricular walls and the right ventricle.
Main Results:
- Thirty patients completed the study.
- Significant decreases were observed in E-wave velocity across all measured left ventricular walls post-BMT (19.2% to 7.5%, p<0.05 for most).
- Time to relaxation significantly prolonged in all LV walls post-BMT (11.1% to 13.7%, p<0.001). Right ventricular E-wave velocity also decreased by 15.6% (p=0.02).
Conclusions:
- Diastolic function is significantly altered after bone marrow transplantation.
- The study provides evidence of impaired left and right ventricular diastolic function post-BMT.
- Further research is needed to understand the clinical implications of these diastolic changes.
Introduction:
High-dose chemotherapy and bone marrow transplantation result in direct and indirect changes in cardiac function. the finding suggests a decreased left ventricular diastolic compliance after high-dose cyclophosphamide treatment, but the effects of bone marrow transplantation (BMT) on cardiac diastolic function are less studied. We aimed to evaluate changes before and after the procedure in cardiac diastolic function in patients undergoing BMT.
Design And Methods:
We designed this study to evaluate the effects of BMT on diastolic cardiac function. Patients with lymphoma (Hodgkin's and non-Hodgkin's), multiple myeloma, and solid tumors who were candidates for autologous BMT were selected for the study. The patients underwent a cardiac consultation and echocardiography before their admission for BMT. E-wave velocity and time to relaxation by tissue Doppler echocardiography in the septal, lateral, anterior, inferior, anteroseptal, and posterior wall; and the E-wave velocity of the right ventricle (RV) were measured before and after BMT.
Result:
Thirty patients fulfilled our inclusion criteria and entered the study. The mean diastolic function measures were calculated before and after BMT. E-wave velocity in the septal, lateral, anterior, inferior, anteroseptal and posterior walls after transplantation decreased by 19.2% (p=0.008), 14.5% (p=0.008), 22.19% (p=0.3), 18.9% (p<0.001), 21.9% (p=0.01), and 7.5% (p=0.01), respectively. The time to relaxation decreased by 13.5%, 13.7%, 12.4%, 11.4%, 11.1%, and 13.1%, respectively, after transplantation (p<0.001). E-wave velocity of RV decreased 15.6% after BMT (p=0.02).
Conclusion:
Data regarding alterations in diastolic functioning after BMT are scarce. This study suggests that diastolic function alters after BMT.
