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Early Impact of Mobilization Process on Cardiac Function and Size in Patients Undergoing Autologous Hematopoietic
Audrone Vaitiekiene1, Migle Kulboke2, Monika Bieseviciene1
1Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania.
Insights
Hematopoietic stem cell transplantation (HSCT) mobilization can reduce right ventricular systolic function. Echocardiographic S
Area of Science:
- Cardiology
- Hematology
- Oncology
Background:
- Hematopoietic stem cell transplantation (HSCT) is associated with cardiac toxicity.
- The mobilization procedure for HSCT involves chemotherapy and filgrastim.
- Assessing early cardiac effects of HSCT mobilization is crucial.
Purpose of the Study:
- To evaluate the impact of stem cell mobilization on left and right ventricular function in autologous HSCT patients.
- To identify specific cardiac parameters affected by the mobilization procedure.
- To determine if early detection of cardiotoxicity is possible.
Main Methods:
- Analysis of data from 47 patients undergoing autologous HSCT.
- Echocardiography performed before and after stem cell mobilization.
- Measurement of left and right ventricular dimensions and systolic/diastolic function.
Main Results:
- A statistically significant decrease in right ventricular systolic function (S') was observed post-mobilization (p=0.003).
- Mean S' decreased from 13.93 ± 2.85 cm/s to 12.19 ± 2.64 cm/s.
- No significant changes were noted in left ventricular size or function, or right ventricular size.
Conclusions:
- The stem cell mobilization procedure in autologous HSCT is linked to reduced right ventricular systolic function.
- Echocardiographic S' can serve as a reliable indicator for early cardiotoxicity detection in HSCT.
- Monitoring RV function may guide further follow-up and management of HSCT patients.
Abstract:
Background: The hematopoietic stem cell transplantation (HSCT) process is known to cause cardiac toxicity of different grades. In this paper, we aimed to evaluate the impact of mobilization procedure of hematopoietic stem cells for autologous HSCT process for left and right ventricle sizes and functions. Material and Methods: The data of 47 patients undergoing autologous HSCT were analyzed. All patients underwent hematopoietic stem cell mobilization with chemotherapy and filgrastim at 10 µg/kg/d. Echocardiography was performed two times: before enrolling in the transplantation process and after mobilization before the conditioning regimen for transplantation. Changes in left and right ventricle (RV) diameter and systolic and diastolic function of the left ventricle and systolic function of the RV were measured. Results: A statistically significant difference was observed in the change of right ventricular function (S')-it slightly decreased. Mean S' before mobilization was 13.93 ± 2.85 cm/s, and after mobilization it was 12.19 ± 2.64 cm/s (p = 0.003). No statistically significant change in left ventricular diameter and systolic and diastolic function and RV diameter was observed. Conclusions: The mobilization procedure in patients undergoing autologous HSCT is associated with reduced RV systolic function. S' could be used as a reliable tool to evaluate early cardiotoxicity in HSCT patients and guide further follow-up.
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