Left Atrial Function in Patients With Diffuse Large B-Cell Lymphoma Treated With R-CHOP Chemotherapy Regimen: A...

Area of Science:

• Cardiology
• Oncology
• Echocardiography

Background:

• Diffuse large B-cell lymphoma (DLBCL) patients treated with R-CHOP chemotherapy are at risk for cardiotoxicity.
• Cancer therapy-related cardiac dysfunction (CTRCD) can significantly impact patient outcomes.
• Early detection of cardiac alterations is crucial for managing R-CHOP-induced cardiotoxicity.

Purpose of the Study:

• To assess if left atrial (LA) strain parameters can identify early functional changes in DLBCL patients undergoing R-CHOP chemotherapy.
• To determine if these LA strain alterations can prospectively predict the development of CTRCD.
• To evaluate the utility of LA strain and stiffness index in predicting cardiotoxicity.

Main Methods:

• Prospective study of DLBCL patients receiving R-CHOP chemotherapy.
• Serial echocardiography including speckle tracking echocardiography (STE) to measure left ventricular global longitudinal strain (LV GLS) and LA strain parameters (LASr, LAScd, LASct, LASI).
• Patients were categorized into CTRCD and non-CTRCD groups based on LV GLS reduction.

Main Results:

• Seventeen percent of patients developed CTRCD.
• Significant deterioration in LA reservoir strain (LASr) and LA stiffness index (LASI) was observed early and persisted.
• Relative changes in LASr (≥ 23.4%) and LASI (≥ 20.0%) were robust predictors of subsequent CTRCD development.

Conclusions:

• Left atrial strain (LASr) and LA stiffness index (LASI) effectively identify early LA functional alterations in DLBCL patients.
• Relative changes in LASr and LASI serve as reliable predictors for subsequent CTRCD development.
• These findings support the use of LA strain analysis for monitoring cardiotoxicity in DLBCL patients.