Department of Cardiology, Charité-University-Medicine Berlin, Campus Virchow Klinikum (CVK), Augustenburger Platz 1, 13353, Berlin, Germany.
Department of Medicine and Surgery, University of Milano-Bicocca, Milano, Italy.
Int J Cardiovasc Imaging. 2021 Mar;37(3):881-887. doi: 10.1007/s10554-020-02061-7. Epub 2020 Oct 12.
Objective We sought to investigate left ventricular (LV) structure, function and mechanics in the patients with leukemia and lymphoma before initiation of chemotherapy, as well as the relationship between hematological malignancies and reduced LV longitudinal strain. Methods This retrospective investigation included 71 patients with leukemia and lymphoma before chemotherapy and 36 healthy controls. All participants underwent echocardiographic examination before initiation of chemotherapy and radiotherapy. Results LV global longitudinal strain (- 20.2 ± 1.7% vs. - 17.9 ± 3.0%, p < 0.001) was significantly lower in the patients with hematological malignancies than in controls. There was no difference in LV circumferential and radial strains between two observed groups. Subendocardial and subepicardial longitudinal strains were significantly lower in the patients with hematological malignancies (- 20.5 ± 3.6% vs. - 22.5 ± 3.8%, p = 0.001 for subendocardial strain; - 18.0 ± 1.5% vs. - 15.8 ± 2.6%, p < 0.001 for subepicardial strain). Hematological malignancies were associated with reduced global LV longitudinal strain (OR 21.0; 95%CI 2.04-215.0, p = 0.010) independently of age, gender, heart rate, body mass index, left ventricular ejection fraction, left ventricular mass index, and glucose level. Conclusions LV longitudinal strain was impaired in the patients with leukemia and lymphoma even before initiation of chemotherapy. Endocardial and epicardial LV layers are equally affected in the patients with hematological malignancies. Newly diagnosed hematological malignancies were related with reduced LV global longitudinal strain independently of common clinical and echocardiographic parameters.
目的 本研究旨在探讨化疗前白血病和淋巴瘤患者的左心室（LV）结构、功能和力学特性，以及血液恶性肿瘤与 LV 纵向应变降低的关系。
方法 本回顾性研究纳入了 71 例化疗前白血病和淋巴瘤患者和 36 名健康对照者。所有参与者在开始化疗和放疗前均接受了超声心动图检查。
结果 与对照组相比，血液恶性肿瘤患者的 LV 整体纵向应变（-20.2±1.7% vs. -17.9±3.0%，p<0.001）明显降低。两组间 LV 环向和径向应变无差异。血液恶性肿瘤患者的心内膜下和心外膜下纵向应变明显降低（心内膜下应变：-20.5±3.6% vs. -22.5±3.8%，p=0.001；心外膜下应变：-18.0±1.5% vs. -15.8±2.6%，p<0.001）。血液恶性肿瘤与 LV 整体纵向应变降低独立相关（OR 21.0；95%CI 2.04-215.0，p=0.010），与年龄、性别、心率、体重指数、左心室射血分数、左心室质量指数和血糖水平无关。
结论 即使在化疗前，白血病和淋巴瘤患者的 LV 纵向应变就已受损。血液恶性肿瘤患者的心内膜和心外膜 LV 层均受到影响。新发血液恶性肿瘤与 LV 整体纵向应变降低独立相关，与常见的临床和超声心动图参数无关。
