Acute Leukemia is Associated with Cardiac Alterations before Chemotherapy

Acute Leukemia is Associated with Cardiac Alterations before Chemotherapy

Author Assuncao, Bruna Morhy Borges Leal Autor UNIFESP Google Scholar
Handschumacher, Mark D. Google Scholar
Brunner, Andrew M. Google Scholar
Yucel, Evin Google Scholar
Bartko, Philipp E. Google Scholar
Cheng, Kai-Hung Google Scholar
Campos, Orlando Autor UNIFESP Google Scholar
Fathi, Amir T. Google Scholar
Tan, Timothy C. Google Scholar
Scherrer-Crosbie, Marielle Google Scholar
Abstract Background: Patients with acute leukemia (AL) have a higher rate of congestive heart failure than patients with other cancers. AL may predispose to cardiac dysfunction before chemotherapy because of high cytokine release or direct leukemic myocardial infiltration. The aims of this study were to evaluate whether AL is associated with abnormalities of myocardial structure and function before chemotherapy and to identify possible risk factors associated with these myocardial changes. Methods: Using an echocardiographic database, 76 patients with AL and 76 patients without cancer matched for age, gender, hypertension, and the presence of diabetes were retrospectively selected. Subsequently, to assess the effect of a nonhematologic malignancy, 28 women in each group were matched with women with breast cancer. Left ventricular (LV) mass, volumes, ejection fraction, and global longitudinal strain (GLS) were measured before chemotherapy. Results: The patients were predominantly male (63%), with a median age of 51 years, and had low prevalence of cardiovascular risk factors. Despite similar LV ejection fractions, patients with AL had higher LV mass and volumes and lower GLS (-19.3 +/- 2.7% vs -20.9 +/- 1.9%, P <.001) than patients without cancer. Similarly, GLS was lower in women with AL compared with women with breast cancer or without cancer. Among patients with AL, high body mass index, low LV ejection fraction, and a small number of circulating lymphocytes were all independently associated with low GLS. Conclusions: Patients with AL had higher LV volumes and lower GLS than patients without cancer and lower GLS than patients with breast cancer, suggesting that AL by itself may be associated with these cardiac alterations.
Keywords Acute leukemia
Two-dimensional speckle-tracking strain
Left ventricular function
Echocardiography
Lymphocyte count
xmlui.dri2xhtml.METS-1.0.item-coverage New York
Language English
Sponsor CAPES Foundation, Brazil
National Institutes of Health
Grant number CAPES: 99999.002830/2015-09
National Institutes of Health: T32 CA071345
Date 2017
Published in Journal Of The American Society Of Echocardiography. New York, v. 30, n. 11, p. 1111-1118, 2017.
ISSN 0894-7317 (Sherpa/Romeo, impact factor)
Publisher Mosby-Elsevier
Extent 1111-1118
Origin http://dx.doi.org/10.1016/j.echo.2017.07.016
Access rights Closed access
Type Article
Web of Science ID WOS:000414255300008
URI https://repositorio.unifesp.br/handle/11600/58304

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