Impaired right ventricular function in long-term survivors of allogeneic haematopoietic stem-cell transplantation
Aims Survivors of allogeneic haematopoietic stem-cell transplantation (allo-HSCT) are at higher risk of cardiovascular disease. We aimed to describe right ventricular (RV) systolic function and risk factors for RV dysfunction in long-term survivors of allo-HSCT performed in their youth.Methods and r...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2021-12-01
|
| Series: | Open Heart |
| Online Access: | https://openheart.bmj.com/content/8/2/e001768.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1846170616625889280 |
|---|---|
| author | Lars Gullestad Anette Borger Kvaslerud Svend Aakhus Jan Otto Beitnes Richard John Massey Phoi Phoi Diep Marta Maria Burman Lorentz Brinch Ellen Ruud |
| author_facet | Lars Gullestad Anette Borger Kvaslerud Svend Aakhus Jan Otto Beitnes Richard John Massey Phoi Phoi Diep Marta Maria Burman Lorentz Brinch Ellen Ruud |
| author_sort | Lars Gullestad |
| collection | DOAJ |
| description | Aims Survivors of allogeneic haematopoietic stem-cell transplantation (allo-HSCT) are at higher risk of cardiovascular disease. We aimed to describe right ventricular (RV) systolic function and risk factors for RV dysfunction in long-term survivors of allo-HSCT performed in their youth.Methods and results This cohort included 103 survivors (53% female), aged (mean±SD) 17.6±9.5 years at allo-HSCT, with a follow-up time of 17.2±5.5 years. Anthracyclines were used as first-line therapy for 44.7% of the survivors. The RV was evaluated with echocardiography, and found survivors to have reduced RV function in comparison to a group of healthy control subjects: Tricuspid annular plane systolic excursion, (TAPSE, 20.8±3.7 mm vs 24.6±3.8 mm, p<0.001), RV peak systolic velocity (RV-s’, 11.2±2.3 cm/s vs 12.3±2.3 cm/s, p=0.001), fractional area change (FAC, 41.0±5.2% vs 42.2±5.1%, p=0.047) and RV free-wall strain (RVFWS, −27.1±4.2% vs −28.5±3.3%, p=0.043). RV systolic dysfunction (RVSD) was diagnosed in 14 (13.6%), and was strongly associated with progressive left ventricular systolic dysfunction (LVSD). High dosages of anthracyclines were associated with greater reductions in RV and LV function. Multivariable linear regressions confirmed global longitudinal strain to be a significant independent predictor for reduced RV function.Conclusion Impaired RV function was found in long-term survivors of allo-HSCT who were treated in their youth. This was associated with progressive left ventricle dysfunction, and pretransplant therapies with anthracyclines. The occurrence of RVSD was less frequent and was milder than coexisting LVSD in this cohort. |
| format | Article |
| id | doaj-art-a86a448a9c6542acad83d6b6111285ae |
| institution | Kabale University |
| issn | 2053-3624 |
| language | English |
| publishDate | 2021-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Open Heart |
| spelling | doaj-art-a86a448a9c6542acad83d6b6111285ae2024-11-11T14:15:07ZengBMJ Publishing GroupOpen Heart2053-36242021-12-018210.1136/openhrt-2021-001768Impaired right ventricular function in long-term survivors of allogeneic haematopoietic stem-cell transplantationLars Gullestad0Anette Borger Kvaslerud1Svend Aakhus2Jan Otto Beitnes3Richard John Massey4Phoi Phoi Diep5Marta Maria Burman6Lorentz Brinch7Ellen Ruud8Center for Heart Failure Research, Oslo University Hospital, Oslo, NorwayFaculty of Medicine, Institute for Clinical Medicine, University of Oslo, Oslo, NorwayDepartment of Circulation and Medical Imaging, Norges teknisk-naturvitenskapelige universitet, Trondheim, NorwayCardiology, Oslo University Hospital, Oslo, NorwayDepartment of Cardiology, Oslo universitetssykehus Hjerte- lunge- og karklinikken, Oslo, NorwayInstitute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, NorwayInstitute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, NorwayHematology, Oslo University Hospital, Oslo, NorwayInstitute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, NorwayAims Survivors of allogeneic haematopoietic stem-cell transplantation (allo-HSCT) are at higher risk of cardiovascular disease. We aimed to describe right ventricular (RV) systolic function and risk factors for RV dysfunction in long-term survivors of allo-HSCT performed in their youth.Methods and results This cohort included 103 survivors (53% female), aged (mean±SD) 17.6±9.5 years at allo-HSCT, with a follow-up time of 17.2±5.5 years. Anthracyclines were used as first-line therapy for 44.7% of the survivors. The RV was evaluated with echocardiography, and found survivors to have reduced RV function in comparison to a group of healthy control subjects: Tricuspid annular plane systolic excursion, (TAPSE, 20.8±3.7 mm vs 24.6±3.8 mm, p<0.001), RV peak systolic velocity (RV-s’, 11.2±2.3 cm/s vs 12.3±2.3 cm/s, p=0.001), fractional area change (FAC, 41.0±5.2% vs 42.2±5.1%, p=0.047) and RV free-wall strain (RVFWS, −27.1±4.2% vs −28.5±3.3%, p=0.043). RV systolic dysfunction (RVSD) was diagnosed in 14 (13.6%), and was strongly associated with progressive left ventricular systolic dysfunction (LVSD). High dosages of anthracyclines were associated with greater reductions in RV and LV function. Multivariable linear regressions confirmed global longitudinal strain to be a significant independent predictor for reduced RV function.Conclusion Impaired RV function was found in long-term survivors of allo-HSCT who were treated in their youth. This was associated with progressive left ventricle dysfunction, and pretransplant therapies with anthracyclines. The occurrence of RVSD was less frequent and was milder than coexisting LVSD in this cohort.https://openheart.bmj.com/content/8/2/e001768.full |
| spellingShingle | Lars Gullestad Anette Borger Kvaslerud Svend Aakhus Jan Otto Beitnes Richard John Massey Phoi Phoi Diep Marta Maria Burman Lorentz Brinch Ellen Ruud Impaired right ventricular function in long-term survivors of allogeneic haematopoietic stem-cell transplantation Open Heart |
| title | Impaired right ventricular function in long-term survivors of allogeneic haematopoietic stem-cell transplantation |
| title_full | Impaired right ventricular function in long-term survivors of allogeneic haematopoietic stem-cell transplantation |
| title_fullStr | Impaired right ventricular function in long-term survivors of allogeneic haematopoietic stem-cell transplantation |
| title_full_unstemmed | Impaired right ventricular function in long-term survivors of allogeneic haematopoietic stem-cell transplantation |
| title_short | Impaired right ventricular function in long-term survivors of allogeneic haematopoietic stem-cell transplantation |
| title_sort | impaired right ventricular function in long term survivors of allogeneic haematopoietic stem cell transplantation |
| url | https://openheart.bmj.com/content/8/2/e001768.full |
| work_keys_str_mv | AT larsgullestad impairedrightventricularfunctioninlongtermsurvivorsofallogeneichaematopoieticstemcelltransplantation AT anetteborgerkvaslerud impairedrightventricularfunctioninlongtermsurvivorsofallogeneichaematopoieticstemcelltransplantation AT svendaakhus impairedrightventricularfunctioninlongtermsurvivorsofallogeneichaematopoieticstemcelltransplantation AT janottobeitnes impairedrightventricularfunctioninlongtermsurvivorsofallogeneichaematopoieticstemcelltransplantation AT richardjohnmassey impairedrightventricularfunctioninlongtermsurvivorsofallogeneichaematopoieticstemcelltransplantation AT phoiphoidiep impairedrightventricularfunctioninlongtermsurvivorsofallogeneichaematopoieticstemcelltransplantation AT martamariaburman impairedrightventricularfunctioninlongtermsurvivorsofallogeneichaematopoieticstemcelltransplantation AT lorentzbrinch impairedrightventricularfunctioninlongtermsurvivorsofallogeneichaematopoieticstemcelltransplantation AT ellenruud impairedrightventricularfunctioninlongtermsurvivorsofallogeneichaematopoieticstemcelltransplantation |