Udin Michael H, Sunder Sunitha Shyam, Nepali Sarmila, Kattel Sharma, Abdelradi Amr, Doyle Scott T, Ionita Ciprian N, Liu Qian, Sharma Umesh C, Pokharel Saraswati
Department of Pathology and Laboratory Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA.
Department of Biomedical Engineering, University at Buffalo, Buffalo, NY, USA.
Cardiooncology. 2024 Dec 19;10(1):90. doi: 10.1186/s40959-024-00285-3.
Cancer patients are known to be associated with increased risk of cardiovascular disease. However, no studies have examined the differential impact of hematologic malignancies (HMs) and solid tumors (STs) on cardiac morphology at the tissue level.
We aimed to examine histopathological features alongside cardiovascular biomarkers in patients with HMs and STs who underwent post-mortem evaluation.
We analyzed cardiac changes in 198 patients with HMs and 164 patients with solid tumors STs. We compared demographics, echocardiogram data, exposure to various antineoplastic agents, and post-mortem findings. Additionally, cardiac histological validation was conducted on post-mortem cardiac specimens to examine cardiac tissue morphology, focusing on cardiomyocyte nuclear density, collagen content, and collagen fiber orientation.
HM patients displayed significantly disordered collagen fiber alignment (0.71 vs 0.83, P = 0.027), and reduced cardiomyocyte nuclear density (56 vs 72, P = 0.002) compared to ST patients. Similarly, hemoglobin level was decreased (6.71 vs 8.06, P < 0.001) in HM patients compared to ST patients. HM patients also showed elevated B-type natriuretic peptide levels (2,275 vs 867, P < 0.001), without significant differences in creatine-kinase MB and cardiac troponin levels. Multivariate analysis identified increased right ventricular thickness, low diastolic blood pressure, and high cardiac troponin levels as risk factors for cardiac death in HM patients.
This study demonstrates that HM patients have fewer cardiomyocyte nuclei and poorly aligned collagen, with serum biomarker evidence of increased cardiac dysfunction. This supports the necessity for specialized cardiac care for these patients.
已知癌症患者患心血管疾病的风险增加。然而，尚无研究在组织水平上探讨血液系统恶性肿瘤（HMs）和实体瘤（STs）对心脏形态的不同影响。
我们旨在研究接受尸检评估的HMs和STs患者的组织病理学特征以及心血管生物标志物。
我们分析了198例HMs患者和164例实体瘤STs患者的心脏变化。我们比较了人口统计学、超声心动图数据、各种抗肿瘤药物的暴露情况以及尸检结果。此外，对尸检心脏标本进行心脏组织学验证，以检查心脏组织形态，重点关注心肌细胞核密度、胶原含量和胶原纤维方向。
与ST患者相比，HM患者的胶原纤维排列明显紊乱（0.71对0.83，P = 0.027），心肌细胞核密度降低（56对72，P = 0.002）。同样，与ST患者相比，HM患者的血红蛋白水平降低（6.71对8.06，P < 0.001）。HM患者的B型利钠肽水平也升高（2275对867，P < 0.001），肌酸激酶MB和心肌肌钙蛋白水平无显著差异。多变量分析确定右心室厚度增加、舒张压降低和心肌肌钙蛋白水平升高是HM患者心脏死亡的危险因素。
本研究表明，HM患者的心肌细胞核较少，胶原排列不佳，血清生物标志物显示心脏功能障碍增加。这支持了对这些患者进行专门心脏护理的必要性。
