Xiao Wei, Ma Linlu, Shang Yufeng, Yang Fuwei, Tan Yuxin, Chen Guopeng, Wu Jinxian, Liang Yuxing, Rouzi Tuerxunayi, Wang Qian, Zhang Nan, Zhou Fuling
Department of Hematology, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China.
Front Med (Lausanne). 2022 Jun 9;9:844350. doi: 10.3389/fmed.2022.844350. eCollection 2022.
The relationship between newly diagnosed acute leukemia (AL) and heart-related lesions remains unclear. This study aimed to investigate baseline cardiac function and risk of cardiovascular diseases (CVDs) in patients with new-onset AL, and provide data on cardiac management strategies for patients with AL. We retrospectively collected data on baseline characteristics, echocardiography, and biochemical blood indicators (e.g., myocardial enzymes) from 408 patients, 200 with newly diagnosed AL, 103 with coronary artery disease (CAD), and 105 controls from January 1, 2015 to August 31, 2019. The creatine kinase isoenzyme myocardial band, lactate dehydrogenase, highly sensitive troponin-I, and B-type natriuretic peptide levels and left ventricular internal diameter (LVID) were significantly higher in patients with newly diagnosed AL than in the control group. The degree of cardiac damage was lower in newly diagnosed AL patients than in CAD patients. The best predictor of heart damage was LVID (AUC [area under the curve] = 0.709; 95% CI [confidence interval]: 0.637-0.781; < 0.001), and independent prognostic risk factors were age and ejection fraction (HR [hazard ratio] = 1.636; 95% CI: 1.039-2.575; = 0.033). The ratio of leukemia blasts among patients with AL was positively correlated with cardiac damage. Our data indicated that newly diagnosed AL patients had certain myocardial damage before treatment. Clinicians need to pay attention to these manifestations, which may be related to the prognosis.
新诊断的急性白血病（AL）与心脏相关病变之间的关系仍不清楚。本研究旨在调查新发AL患者的基线心脏功能和心血管疾病（CVD）风险，并提供AL患者心脏管理策略的数据。我们回顾性收集了2015年1月1日至2019年8月31日期间408例患者的基线特征、超声心动图和血液生化指标（如心肌酶）数据，其中200例为新诊断的AL患者，103例为冠状动脉疾病（CAD）患者，105例为对照组。新诊断的AL患者的肌酸激酶同工酶心肌型、乳酸脱氢酶、高敏肌钙蛋白I、B型利钠肽水平和左心室内径（LVID）显著高于对照组。新诊断的AL患者的心脏损伤程度低于CAD患者。心脏损伤的最佳预测指标是LVID（曲线下面积[AUC]=0.709；95%置信区间[CI]：0.637-0.781；<0.001），独立的预后危险因素是年龄和射血分数（风险比[HR]=1.636；95%CI：- 1.039-2.575；=0.033）。AL患者中白血病原始细胞的比例与心脏损伤呈正相关。我们的数据表明，新诊断的AL患者在治疗前有一定的心肌损伤。临床医生需要关注这些表现，这可能与预后有关。
