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Serial Changes in Cardiac Strain and Contractility After Hematopoietic Stem Cell Transplantation in Patients with
Toru Oka1, Yuma Tada2, Makiko Oboshi1
1Department of Onco-Cardiology, Osaka International Cancer Institute.
Insights
Hematopoietic stem cell transplantation (HSCT) can cause cardiac issues. Global longitudinal strain (GLS) decreases post-HSCT, indicating potential long-term heart problems in patients with hematologic malignancies.
Area of Science:
- Cardiology
- Hematology
- Oncology
Background:
- Hematopoietic stem cell transplantation (HSCT) is a critical treatment for hematologic malignancies.
- Cardiac dysfunction is a recognized complication following HSCT.
- Global longitudinal strain (GLS) is a sensitive marker for early cardiotoxicity.
Purpose of the Study:
- To investigate the serial changes in GLS before and after HSCT.
- To determine the association between GLS and cardiac function post-HSCT.
- To identify potential predictors of HSCT-associated cardiotoxicity.
Main Methods:
- Prospective evaluation of 38 HSCT patients.
- Serial assessment of GLS and left ventricular ejection fraction (LVEF) at baseline, and 1, 3, and 6 months post-HSCT.
- Comparison of GLS and LVEF between patients with normal and low LVEF at 6 months.
Main Results:
- Both GLS and LVEF decreased at 1 month post-HSCT.
- LVEF recovered by 3 months, while GLS showed partial recovery by 6 months.
- Consistently lower GLS was observed in patients who developed low LVEF post-HSCT.
Conclusions:
- Serial GLS monitoring may predict cardiac dysfunction after HSCT.
- Pre-HSCT GLS may be associated with post-HSCT LVEF decline in hematologic malignancy patients.
- Further long-term studies are needed to guide management of HSCT-related cardiac dysfunction.
Abstract:
Hematopoietic stem cell transplantation (HSCT) is occasionally associated with cardiac dysfunction during long-term follow-up. Global longitudinal strain (GLS) has emerged as an early predictor of cardiotoxicity associated with cancer therapy; however, the serial changes in GLS before and after HSCT have not been elucidated. To clarify the association between HSCT and GLS, we investigated serial changes in GLS before and after HSCT. We evaluated cardiac function before and 1, 3, and 6 months after HSCT in 38 consecutive HSCT patients enrolled in this study. Overall, GLS and left ventricular (LV) ejection fraction (EF) temporally decreased 1 month post-HSCT. LVEF completely recovered to baseline at 3 months after HSCT, whereas GLS partially recovered 6 months after HSCT. Except for five patients who died within 6 months, GLS values in the low EF group (LVEF ≤ 55% at 6 months post-HSCT, n = 6) were significantly and consistently lower than those in the normal EF group (LVEF > 55% at 6 months post-HSCT, n = 27) at any time during follow-up. These findings suggest that GLS before HSCT might be associated with a decrease in LVEF after HSCT in patients with hematologic malignancies. Further prospective and long-term data will be important for understanding the management of HSCT-associated cardiac dysfunction.
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