Evaluation of left ventricular function in patients with Non-Hodgkin’s lymphoma undergoing chemotherapy

Abstract

Introduction. Non-Hodgkin's lymphoma is the most common hematologic malignancy with an increased risk for cardiovascular complications due to the applied treatment. Echocardiographic evaluation could lead to early detection of cardiotoxicity. Materials and methods. A sample of 83 consecutive patients who underwent chemotherapy (CTx), excluding those who received chemo- or radiotherapeutic treatment, with known coronary/myocardial diseases, moderate or severe valvulopathies. Echocardiography was performed at baseline, and at 6-month follow-up. Cancer therapy-related cardiac dysfunction (CTRCD) was defined as new left ventricular ejection fraction (LVEF) reduction by ≥10 percentage points to an LVEF of 40–49%. Results. LVEF decreased from 63.2 ± 4.5 % to 57.5 ± 4.7 % during follow up (p <0.001), also significantly increased the left ventricular end-diastolic diameter from 47.2 ± 5.2 mm to 54.3 ± 5.3 mm (p <0.001), other parameters as the left-ventricular myocardial performance index and systolic velocity of mitral septal annulus did not achieve statistically significant differences (p = 0.560 and p = 0.430 respectively). E/e’ was 10.3 ± 4.3 increased to 11.4 ± 5.6 (p=0.233), left atrial volume index increased from 29.4 ± 5.6 ml/m2 to 36.2 ± 4.3 ml/m2 (p < 0.001), the ratio of color M-mode flow propagation velocity to early diastolic trans – mitral flow velocity (E/ Vp) increased at 6-month follow-up compared with baseline (1.6 ± 0.3 and 1.3 ± 0.4, p < 0.001, respectively). CTRCD was assessed in 9 patients (9.63%). Conclusion. CTx has an impact on left ventricular function and the parameters above could be used for predicting CTRCD.