Camilli Massimiliano, Ballacci Federico, Lamendola Priscilla, Viscovo Marcello, Tamburrini Giulia, Tinti Lorenzo, Torre Ilaria, Amore Ludovica, Hohaus Stefan, Crea Filippo, Lanza Gaetano Antonio, Burzotta Francesco, Minotti Giorgio, Lombardo Antonella
Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy.
Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go A. Gemelli, 1 - 00168, Rome, Italy.
Cardiooncology. 2025 Aug 30;11(1):78. doi: 10.1186/s40959-025-00373-y.
AIMS: Adult survivors of haematological malignancies are at increased risk of long-term cardiovascular sequelae. Several echocardiographic metrics have been tested to detect subclinical myocardial dysfunction before it progresses toward cardiac events. Myocardial work (MW) is a load-independent echocardiographic index that conjugates non-invasive arterial blood pressure and global longitudinal strain (GLS). METHODS: Sixty-three disease-free survivors of Hodgkin Lymphoma (HL) [49% male, median age 42 (33,0-50,5) years], without known cardiovascular disease or reported cardiological symptoms, were included in this observational study. Myocardial work data from cancer survivors were compared with those from healthy subjects recruited in the EACVI NORRE Study. RESULTS: Mean left ventricular ejection fraction and GLS were, respectively, 57,0% (55,0-60,0) and - 18,0% (-19,2-17,1). Global work efficiency [GWE, 96% (94-97)], global work index (GWI, 1732 ± 340 mmHg%) and global wasted work [GWW, 78 (55-131) mmHg%] did not differ between male and female survivors; however, global constructive work (GCW, 2116 ± 386 mmHg%) was lower in males. Of importance, GWI and GCW were lower in cancer survivors compared to healthy subjects from the EACVI NORRE study (p = 0,0008 and p = 0,0324, respectively). When evaluating associations of MW indices with patients' characteristics, only systolic blood pressure and ejection fraction were independently associated with both GWI and GCW at multivariable analysis. CONCLUSION: For the first time, this report provides values of MW indices in asymptomatic HL survivors without cardiovascular disease. GWI and GCW were significantly lower in HL survivors compared to healthy subjects. MW metrics might serve as valuable markers of subclinical cardiac dysfunction in this population.
目的:血液系统恶性肿瘤的成年幸存者发生长期心血管后遗症的风险增加。已经对几种超声心动图指标进行了测试,以在亚临床心肌功能障碍进展为心脏事件之前进行检测。心肌做功(MW)是一种与负荷无关的超声心动图指标,它结合了无创动脉血压和整体纵向应变(GLS)。 方法:本观察性研究纳入了63例霍奇金淋巴瘤(HL)的无病幸存者[男性占49%,中位年龄42(33.0 - 50.5)岁],这些患者无已知心血管疾病或报告的心脏症状。将癌症幸存者的心肌做功数据与欧洲心血管影像学会(EACVI)北欧研究中招募的健康受试者的数据进行比较。 结果:平均左心室射血分数和GLS分别为57.0%(55.0 - 60.0)和 - 18.0%(-19.2 - 17.1)。整体做功效率[GWE,96%(94 - 97)]、整体做功指数(GWI,1732±340 mmHg%)和整体无用功[GWW,78(55 - 13l)mmHg%]在男性和女性幸存者之间无差异;然而,男性的整体建设性做功(GCW,2116±386 mmHg%)较低。重要的是,与EACVI北欧研究中的健康受试者相比,癌症幸存者的GWI和GCW较低(分别为p = 0.0008和p = 0.0324)。在评估MW指标与患者特征的关联时,在多变量分析中,只有收缩压和射血分数与GWI和GCW均独立相关。 结论:本报告首次提供了无心血管疾病的无症状HL幸存者的MW指标值。与健康受试者相比,HL幸存者的GWI和GCW显著较低。MW指标可能是该人群亚临床心脏功能障碍的有价值标志物。
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