Association of abnormal P-wave parameters with all-cause mortality in diffuse large B-cell lymphoma
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Published on: February 12, 2022
Hanzhi Du1, Qinghua Tang2, Yuye Ning3
1Department of Hematology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China.
Insights
Abnormal P-wave parameters (PWPs) predict mortality in diffuse large B-cell lymphoma (DLBCL) patients. Monitoring PWPs, especially in males, can improve prognosis assessment for DLBCL.
Area of Science:
- Cardiology
- Hematology
- Oncology
Background:
- Diffuse large B-cell lymphoma (DLBCL) patients have an increased risk of atrial fibrillation (AF).
- Abnormal P-wave parameters (PWPs) are known AF predictors, but their prognostic role in DLBCL is unclear.
Purpose of the Study:
- To investigate the prognostic significance of PWPs in predicting all-cause mortality among newly diagnosed DLBCL patients.
- To identify risk factors associated with abnormal PWPs in this cohort.
Main Methods:
- Retrospective study of 374 DLBCL patients diagnosed between January 2015 and August 2022.
- Analysis of P-wave parameters (PWPs) and their correlation with all-cause mortality using Kaplan-Meier and Cox regression models.
- Logistic regression used to identify risk factors for abnormal PWPs.
Main Results:
- 137 patients (36.6%) had abnormal PWPs.
- Abnormal PWPs were associated with higher all-cause mortality (p=0.001), male sex (p=0.001), elevated blood urea nitrogen (p=0.038), and creatinine (p=0.005).
- P-wave duration and P-wave terminal force in lead V1 (PTFV1) were independent predictors of mortality.
Conclusions:
- PWPs, specifically P-wave duration and PTFV1, are simple and effective prognostic indicators for all-cause mortality in DLBCL patients.
- Vigilant monitoring of PWPs, particularly in male DLBCL patients, is recommended for prognosis evaluation.
Abstract:
Patients diagnosed with diffuse large B-cell lymphoma (DLBCL) are at increased risk of developing atrial fibrillation (AF). Abnormal P-wave parameters (PWPs) have been identified as independent predictors of AF, however, their prognostic significance in DLBCL patients remains unknown. Newly diagnosed DLBCL patients from January 2015 to August 2022 were retrospectively included in this study. Patients were devided as with abnormal PWPs or without it. Primary outcome was the all-cause mortality. The median duration of follow-up was 16.3 months. The Kaplan‒Meier method and multivariable COX proportional hazards regression models were used to analyze the relationship between PWPs and all-cause mortality. Logistic regression analyses were performed to identify risk factors associated with PWPs. A total of 374 newly diagnosed DLBCL patients were included, of whom 137 patients exhibited abnormalities in PWPs. Compared to the group with normal PWPs, patients with PWPs abnormalities had a higher proportion of males (p = 0.001), elevated levels of blood urea nitrogen (p = 0.038) and blood creatinine (p = 0.005), and a higher rate of all-cause mortality (p = 0.001). PWPs, particularly P-wave duration (p = 0.017) and P-wave terminal force in lead V1 (PTFV1) (p = 0.001), were independently correlated with all-cause mortality in DLBCL patients. Furthermore, male patients exhibited a higher susceptibility to abnormal PWPs (p = 0.001). PWPs, particularly P-wave duration and PTFV1, serve as simple yet effective prognostic indicators for all-cause mortality in DLBCL patients. Consequently, vigilant monitoring of PWPs, particularly in male patients, is warranted to accurately evaluate the prognosis of DLBCL.
