[High cardiac output in myeloma patients. Its prevalence and clinical characteristics. The Castile-León Cooperative Group for the Study of Monoclonal Gammapathies].

BACKGROUND

The study determines the prevalence of high cardiac output status in patients with multiple myeloma (MM) and its relationship with the more significant clinical and biological characteristics of the disease.

PATIENTS AND METHODS

Cardiac output was determined in 28 patients with multiple myeloma by pulsed Doppler echocardiography. Patients with any other identifiable cause of high cardiac output were excluded. Mean age was 70 +/- 8 SD years (53-84). A stepwise regression with the cardiac output as dependent variable and age, performance status (ECOG), clinical stage (Durie and Salmon), scale of bone lesions, serum calcium, serum creatine, bone involvement (percentage), and M protein quantity as independent variables showed the following results.

RESULTS

A high cardiac output state, defined as a cardiac index higher than 4.6 l/min/m2 was present in five patients (17.8%), four of them with severe bone involvement. Two patients developed heart failure. The stepwise regression revealed the scale of bone lesions was the unique variable associated with the risk of developing a high cardiac output status.

CONCLUSIONS

A high cardiac output status may be fairly common in patients with multiple myeloma. The syndrome is associated with severe bone involvement, being the scale of bone lesions the only risk factor for this complication.