Evaluation of right ventricle functions might be a method for early recognizing cardiotoxicity in hematopoietic stem cell transplantation

Abstract

Objective: We aimed to investigate whether right ventricular (RV) functional assessment by echocardiography may help in the early diagnosis of hematopoietic stem cell transplantation (HSCT)-induced cardiotoxicity. Methods: Our study population comprised 41 autologous multiple myeloma, 25 autologous Hodgkin's lymphoma, 20 autologous and 19 allogeneic non-Hodgkin's lymphoma, 10 allogeneic acute myeloid leukemia, 12 allogeneic myelodysplastic syndrome, and 10 allogeneic aplastic anemia patients. Conventional two-dimensional echocardiographic and tissue Doppler imaging examination of the patients were performed before and after HSCT. Post-HSCT values were compared with pre-HSCT values. Results: The mean age of the patients was 46.51 ± 16.24 years, and the mean hospital length of stay and the mean leukocyte engraftment time were 30 and 11 days, respectively. The number of female and male patients was 60 (43.8%) and 77 (56.2%), respectively. There were no significant differences in echocardiographic parameters including left ventricular end-diastolic diameter, left ventricular end-systolic diameter, left ventricular ejection fraction, RV, right atrium, pulmonary artery pressure, pulmonary velocity, Pulmonary acceleration time (PAT)/ pulmonary ejection time (PET), PAT, E, A wave velocity, E/A ratio, and DT and A' velocity before and after HSCT. Compared to pretransplant values, posttransplant values of the E' velocity, S' velocity, E'/A' ratio, and tricuspid annular plane systolic excursion showed a statistically significant decrease (0.15 ± 0.34 vs. 0.12 ± 0.04, P = 0.032; 0.19 ± 0.06 vs. 0.09 ± 0.04, P < 0.001; 0.90 ± 0.40 vs. 0.72 ± 0.37, P = 0.012; and 2.30 ± 0.39 vs. 1.63 ± 0.30, P <0.001, respectively). Conclusion: Assessment of RV functions might be useful for the prediction of early cardiotoxicity in patients undergoing HSCT.