Evaluating Diastolic Function by Echocardiography in a Prospective Cohort of Patients with Hodgkin (HL) and Non-Hodgkin Lymphoma (NHL) Who Received Anthracycline-Based Chemotherapy
Document Type
Article
Publication Title
Circulation
Abstract
Introduction: Anthracyclines are a first-line chemotherapeutic agent used in the treatment of lymphoma. Myocardial injury can occur with cumulative doses of 250 to 350 mg/m2. Echocardiography is the imaging modality for identifying cardiac dysfunction; however, identifying diastolic changes in patients who received anthracyclines is not well represented in the literature. Variables used to identify diastolic dysfunction include lateral e’, medial e’, mitral E velocity, mitral A velocity, E/A, E/e’, and left atrial volume index (LAVI). This study aims to identify if diastolic abnormalities develop in a prospective cohort of patients with HL or NHL who received anthracycline-based chemotherapy. Methods: Lymphoma patients treated with anthracyclines from 2013 to 2020 were prospectively enrolled. Echocardiography was obtained at 3-time points: before the start of chemotherapy (T1), at 3-6 months (T2), and 9-12 months (T3). Diastolic variables were measured and analyzed based on the total cumulative dose of Doxorubicin per body surface area. Those that received greater than 250 mg/m2 and greater than 300 mg/m2 of Doxorubicin were compared to those that did not. Statistical analysis was done using one-way ANOVA, adjusting for age and gender. Results: 151 total patients (90 males, mean age 61+16 years); 21 (14%) HL, 130 (85%) NHL. 114 and 66 patients received a total cumulative dose of Doxorubicin greater than 250 mg/m2 and 300 mg/m2, respectively. There was no significant association with 250 mg/m2. Lateral e’ at T3 vs. T1, was lower in those that received greater than 300 mg/ m2 compared to those received less (0.09 vs 0.10, p < 0.02) (Table 1). Conclusions: Lateral e’ decreased at 1-year follow-up in those that received higher doses of Doxorubicin. These changes in the lateral e’ could reflect early relaxation abnormalities related to anthracycline-based chemotherapy and suggest that changes in lateral e’ should be considered by itself since E/e’ was normal.
Publication Date
11-8-2021
Recommended Citation
Twfiq, Reema; Boddicker, Nicholas; Quintero Martinez, Joan; Cordova, Sanda; Alam, M M.; Cerhan, James; Herrmann, Joerg; Thompson, Carrie A.; and Villarraga, Hector R., "Evaluating Diastolic Function by Echocardiography in a Prospective Cohort of Patients with Hodgkin (HL) and Non-Hodgkin Lymphoma (NHL) Who Received Anthracycline-Based Chemotherapy" (2021). Cardiology. 92.
https://scholar.bridgeporthospital.org/cardiology/92