Department of Onco-Cardiology, Osaka International Cancer Institute.
Department of Hematology, Osaka International Cancer Institute.
Int Heart J. 2021 May 29;62(3):575-583. doi: 10.1536/ihj.20-434. Epub 2021 May 15.
Hematopoietic stem cell transplantation (HSCT) is occasionally associated with cardiac dysfunction during long-term follow-up. Global longitudinal strain (GLS) has emerged as an early predictor of cardiotoxicity associated with cancer therapy; however, the serial changes in GLS before and after HSCT have not been elucidated. To clarify the association between HSCT and GLS, we investigated serial changes in GLS before and after HSCT. We evaluated cardiac function before and 1, 3, and 6 months after HSCT in 38 consecutive HSCT patients enrolled in this study. Overall, GLS and left ventricular (LV) ejection fraction (EF) temporally decreased 1 month post-HSCT. LVEF completely recovered to baseline at 3 months after HSCT, whereas GLS partially recovered 6 months after HSCT. Except for five patients who died within 6 months, GLS values in the low EF group (LVEF ≤ 55% at 6 months post-HSCT, n = 6) were significantly and consistently lower than those in the normal EF group (LVEF > 55% at 6 months post-HSCT, n = 27) at any time during follow-up. These findings suggest that GLS before HSCT might be associated with a decrease in LVEF after HSCT in patients with hematologic malignancies. Further prospective and long-term data will be important for understanding the management of HSCT-associated cardiac dysfunction.
造血干细胞移植（HSCT）后长期随访中偶尔会出现心脏功能障碍。整体纵向应变（GLS）已成为与癌症治疗相关的心肌毒性的早期预测指标；然而，HSCT 前后 GLS 的连续变化尚未阐明。为了阐明 HSCT 与 GLS 之间的关系，我们研究了 HSCT 前后 GLS 的连续变化。我们在这项研究中评估了 38 例连续 HSCT 患者 HSCT 前后 1、3 和 6 个月的心脏功能。总体而言，HSCT 后 1 个月 GLS 和左心室（LV）射血分数（EF）呈时间性下降。HSCT 后 3 个月 LVEF 完全恢复到基线，而 GLS 在 6 个月后部分恢复。除了 6 个月内死亡的五名患者外，低 EF 组（HSCT 后 6 个月 LVEF ≤ 55%，n = 6）的 GLS 值在任何随访时间均明显且持续低于正常 EF 组（HSCT 后 6 个月 LVEF > 55%，n = 27）。这些发现表明，血液恶性肿瘤患者 HSCT 前的 GLS 可能与 HSCT 后 LVEF 的降低有关。进一步的前瞻性和长期数据对于理解 HSCT 相关心脏功能障碍的管理将非常重要。
