Cardiovascular Function in Long-Term Hematopoietic Cell Transplantation Survivors

Area of Science:

• Cardiology
• Hematology
• Exercise Physiology

Background:

• Peak oxygen consumption (VO2peak) predicts mortality and cardiovascular disease (CVD).
• Hematopoietic cell transplantation (HCT) survivors face high CVD risk.
• Assessing cardiopulmonary health in aging HCT survivors is crucial.

Purpose of the Study:

• Evaluate the safety and feasibility of CPET in aging HCT survivors.
• Determine the impact of organ-specific impairments on VO2peak post-HCT.
• Characterize CVD risk factors in HCT survivors using advanced measures.

Main Methods:

• Twenty HCT survivors underwent CPET, echocardiography with strain, and pulmonary function tests.
• Median age was 67.4 years; median time from HCT was 9.8 years.
• No adverse events occurred during CPET; 95% achieved peak effort.

Main Results:

• VO2peak was 22% lower than predicted.
• Allogeneic HCT survivors had significantly lower VO2peak than autologous survivors.
• 30% had VO2peak ≤ 16 mL/kg/min, a threshold linked to increased mortality.
• 25% showed abnormal left ventricular longitudinal strain despite normal ejection fraction.

Conclusions:

• CPET is safe and feasible for assessing HCT survivors' cardiopulmonary health.
• Reduced VO2peak and subclinical myocardial dysfunction are prevalent in HCT survivors.
• Stress testing and advanced imaging are vital for CVD risk stratification in HCT survivors.
• Findings support tailored interventions to mitigate CVD risk in HCT survivors.