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Prevalence and clinical characteristics of a high cardiac output state in patients with multiple myeloma
W McBride1, J D Jackman, P A Grayburn
1Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas.
Insights
High cardiac output states are common in multiple myeloma patients, affecting nearly 24%. This condition is linked to severe bone disease, not typical causes, and can lead to heart failure.
Area of Science:
- Cardiology
- Hematology
- Oncology
Background:
- Multiple myeloma is a plasma cell malignancy.
- High cardiac output states can complicate various medical conditions.
Purpose of the Study:
- To determine the prevalence of high cardiac output states in multiple myeloma.
- To describe the clinical features associated with this condition.
Main Methods:
- Evaluated 36 multiple myeloma patients.
- Assessed clinical, laboratory, and echocardiographic data.
- Measured cardiac output noninvasively using Doppler echocardiography.
Main Results:
- A high cardiac output state (cardiac index >= 4.0 L/min/m2) was found in 23.5% of patients.
- No known causes of high output states were identified.
- Severe bone involvement was significantly more common in patients with high cardiac output.
Conclusions:
- High cardiac output states are relatively common in multiple myeloma.
- Extensive bone disease is associated with high cardiac output in these patients.
Purpose:
This study was undertaken to define the prevalence and clinical characteristics of patients with a high cardiac output state associated with multiple myeloma.
Patients And Methods:
Specifically, we evaluated clinical, laboratory, and two-dimensional and Doppler echocardiographic data in 36 patients with multiple myeloma. Cardiac output was determined noninvasively by a pulsed Doppler technique.
Results:
A high cardiac output state, defined as a cardiac index greater than or equal to 4.0 L/minute/m2, was present in eight of 34 (23.5%) subjects in whom cardiac output was measurable. None of the known causes of high output states could be identified in these patients. Four patients developed high output congestive heart failure, two of whom died. Age, sex, degree of anemia, serum calcium level, immunoglobulin type, or disease stage did not differ significantly between subjects with or without high output states. However, severe bone involvement was significantly more frequent in those patients with high cardiac output states, occurring in all eight patients with high cardiac indexes compared with nine of 26 patients with low or normal cardiac indexes (p = 0.001).
Conclusion:
These data demonstrate that high cardiac output states are relatively common in patients with multiple myeloma and are associated with the presence of extensive bone disease.