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The Value of Left Atrial Volume Changes in Predicting Cardiotoxicity in Patients Undergoing Anthracycline
Dongliang Chen1, Li Fan1, Yifei Rui1
1Department of Echocardiography, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou 213003, China.
Insights
Three-dimensional echocardiography of left atrial volume effectively predicts cardiotoxicity in multiple myeloma patients receiving anthracycline chemotherapy. Changes in left atrial volume serve as crucial indicators for early detection and management of chemotherapy-induced heart damage.
Area of Science:
- Cardiology
- Oncology
- Medical Imaging
Background:
- Anthracycline chemotherapy is vital for multiple myeloma but poses a risk of cardiotoxicity.
- Early detection of cardiotoxicity is crucial for managing treatment and improving patient outcomes.
- Left atrial volume changes may indicate early cardiac dysfunction.
Purpose of the Study:
- To evaluate the predictive value of three-dimensional echocardiography-derived left atrial volume (LAV) in detecting cardiotoxicity in multiple myeloma patients undergoing anthracycline chemotherapy.
- To compare echocardiographic and serological parameters between patients who develop cardiotoxicity and those who do not.
Main Methods:
- A cohort of 53 multiple myeloma patients receiving anthracycline chemotherapy were monitored over three cycles.
- Three-dimensional echocardiography and serological markers (cTnI, Pro-BNP) were assessed before and after each chemotherapy cycle.
- Multivariate logistic regression and ROC curve analysis were used to identify predictors and assess diagnostic value.
Main Results:
- Patients in the cardiotoxicity group showed significantly higher levels of serological markers (T3 cTnI, T3 Pro-BNP) and left atrial volume parameters (T2/T3 LAVmin, T2/T3 LAVprep) compared to the non-cardiotoxicity group.
- Multivariate analysis identified T3 cTnI, T3 Pro-BNP, and all assessed LAV parameters as independent predictors of cardiotoxicity (P < 0.05).
- Receiver operating characteristic (ROC) curve analysis indicated that T3 LAVmin demonstrated the highest diagnostic efficiency (AUC = 0.938, sensitivity 75.72%, specificity 93.82%).
Conclusions:
- Three-dimensional echocardiography assessment of left atrial volume changes is a valuable tool for predicting anthracycline-induced cardiotoxicity in multiple myeloma patients.
- LAV parameters, particularly T3 LAVmin, offer high diagnostic accuracy for early cardiotoxicity detection.
- Integrating 3D echocardiography into monitoring protocols can aid in timely intervention for chemotherapy-related cardiac complications.
Abstract:
In order to study the value of left atrial volume three-dimensional echocardiography in predicting cardiotoxicity in patients with multiple myeloma undergoing anthracycline chemotherapy, a total of 53 patients with multiple myeloma who are treated in the Department of Hematology of our hospital from January 2018 to December 2020 are selected as the research object, and all patients underwent three cycles (T1-T3) of chemotherapy. Before and after each cycle of chemotherapy, the patients are examined with 3D ultrasound and serology detection. These patients are divided into the cardiotoxicity group and noncardiotoxicity group. The serological indexes and three-dimensional echocardiographic parameters between two groups are compared. Multivariate logistic regression is used to determine the independent risk factors of cardiotoxicity in patients undergoing chemotherapy. And ROC curves are performed to evaluate the diagnostic value of related indicators in predicting cardiotoxicity. A total of 53 patients with multiple myeloma are included in this study. Serological indexes (T3 cTnI and T3 Pro-BNP), T2 LAVmin, T3 LAVmin, T2 LAVprep, and T3 LAVprep in the cardiotoxicity group are significantly higher than those in the noncardiotoxicity group. Multivariate logistic regression further found that T3 cTnI, T3 Pro-BNP, T2 LAVmin, T3 LAVmin, T2 LAVprep, T3 LAVprep could be used to predict the occurrence of cardiotoxicity (P < 0.05). The results of ROC curves showed that T3 LAVmin had the most diagnostic efficiency of cardiotoxicity (AUC = 0.938; sensitivity 75.72%; specificity 93.82%). Detection of changes in left atrial volume using three-dimensional ultrasound could be used as strong predictors of cardiotoxicity caused by anthracycline chemotherapy drugs in patients with multiple myeloma.
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