Baseline Global Longitudinal Strain as a Predictor of Left Ventricular Dysfunction and Hospitalization for Heart Failure of Patients With Malignant Lymphoma After Anthracycline Therapy

Keiko Hatazawa; Hidekazu Tanaka; Akiko Nonaka; Hiroki Takada; Fumitaka Soga; Yutaka Hatani; Hiroki Matsuzoe; Hiroyuki Shimoura; Junichi Ooka; Hiroyuki Sano; Yasuhide Mochizuki; Kensuke Matsumoto; Ken-ichi Hirata

doi:10.1253/circj.CJ-18-0333

Heart Failure

Baseline Global Longitudinal Strain as a Predictor of Left Ventricular Dysfunction and Hospitalization for Heart Failure of Patients With Malignant Lymphoma After Anthracycline Therapy

Keiko Hatazawa, Hidekazu Tanaka, Akiko Nonaka, Hiroki Takada, Fumitaka Soga, Yutaka Hatani, Hiroki Matsuzoe, Hiroyuki Shimoura, Junichi Ooka, Hiroyuki Sano, Yasuhide Mochizuki, Kensuke Matsumoto, Ken-ichi Hirata

Author information

Keiko Hatazawa
Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
Hidekazu Tanaka
Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
Akiko Nonaka
Division of Cardiology, Hyogo Cancer Center
Hiroki Takada
Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
Fumitaka Soga
Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
Yutaka Hatani
Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
Hiroki Matsuzoe
Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
Hiroyuki Shimoura
Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
Junichi Ooka
Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
Hiroyuki Sano
Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
Yasuhide Mochizuki
Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
Kensuke Matsumoto
Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
Ken-ichi Hirata
Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine

Keywords: Echocardiography, Heart failure, Speckle tracking, Ventricular function

JOURNAL FREE ACCESS FULL-TEXT HTML

2018 Volume 82 Issue 10 Pages 2566-2574

DOI https://doi.org/10.1253/circj.CJ-18-0333

Editorial (82-10 pp. 2477-2478)

Browse “Advance online publication” version

Details

Abstract

Background: Our aim was to investigate the baseline clinical and echocardiographic parameters for predicting left ventricular (LV) dysfunction after anthracycline chemotherapy and heart failure (HF) hospitalization in a single cancer disease.

Methods and Results: We studied 73 patients with malignant lymphoma and preserved LV ejection fraction (LVEF). Echocardiography was performed before and after anthracycline chemotherapy. Global longitudinal strain (GLS) was determined from 3 standard apical views. LV dysfunction after anthracycline chemotherapy was defined according to the current definition of cancer therapeutics-related cardiac dysfunction. Long-term (50-month) unfavorable outcome was prespecified as hospitalization for HF. A total of 10 patients had LV dysfunction after anthracycline chemotherapy. Multivariate logistic regression analysis showed that baseline GLS was the only independent predictor of this dysfunction. Receiver-operating characteristic curve analysis identified the optimal GLS cutoff for predicting LV dysfunction after anthracycline chemotherapy as ≤19% (P=0.008). Furthermore, the Kaplan-Meier curve indicated that fewer patients with GLS >19% were hospitalized for HF than among those with GLS ≤19% (log-rank P=0.02). For sequential logistic models, a model based on baseline clinical variables (χ²=2.9) was improved by the addition of baseline LVEF (χ²=9.0; P=0.01), and further improved by the addition of baseline GLS (χ²=13.1, P=0.04).

Conclusions: Watchful observation or early therapeutic intervention with established cardioprotective medications may be necessary for patients with malignant lymphoma and preserved LVEF but with abnormal GLS.

Corresponding author

Register with J-STAGE for free!