The Value of Left Atrial Volume Changes in Predicting Cardiotoxicity in Patients Undergoing Anthracycline Chemotherapy

In order to study the value of left atrial volume three-dimensional echocardiography in predicting cardiotoxicity in patients with multiple myeloma undergoing anthracycline chemotherapy, a total of 53 patients with multiple myeloma who are treated in the Department of Hematology of our hospital from January 2018 to December 2020 are selected as the research object, and all patients underwent three cycles (T1–T3) of chemotherapy. Before and after each cycle of chemotherapy, the patients are examined with 3D ultrasound and serology detection. These patients are divided into the cardiotoxicity group and noncardiotoxicity group. The serological indexes and three-dimensional echocardiographic parameters between two groups are compared. Multivariate logistic regression is used to determine the independent risk factors of cardiotoxicity in patients undergoing chemotherapy. And ROC curves are performed to evaluate the diagnostic value of related indicators in predicting cardiotoxicity. A total of 53 patients with multiple myeloma are included in this study. Serological indexes (T3 cTnI and T3 Pro-BNP), T2 LAVmin, T3 LAVmin, T2 LAVprep, and T3 LAVprep in the cardiotoxicity group are significantly higher than those in the noncardiotoxicity group. Multivariate logistic regression further found that T3 cTnI, T3 Pro-BNP, T2 LAVmin, T3 LAVmin, T2 LAVprep, T3 LAVprep could be used to predict the occurrence of cardiotoxicity (P < 0.05). The results of ROC curves showed that T3 LAVmin had the most diagnostic efficiency of cardiotoxicity (AUC = 0.938; sensitivity 75.72%; specificity 93.82%). Detection of changes in left atrial volume using three-dimensional ultrasound could be used as strong predictors of cardiotoxicity caused by anthracycline chemotherapy drugs in patients with multiple myeloma.

[1]  Xiaojie Wang,et al.  Advances in Biomarkers for Detecting Early Cancer Treatment-Related Cardiac Dysfunction , 2021, Frontiers in Cardiovascular Medicine.

[2]  E. Boersma,et al.  2D-echocardiography vs cardiac MRI strain: a prospective cohort study in patients with HER2-positive breast cancer undergoing trastuzumab , 2021, Cardiovascular Ultrasound.

[3]  Alexis A Gonzalez,et al.  Association of Cardiotoxicity With Doxorubicin and Trastuzumab: A Double-Edged Sword in Chemotherapy , 2021, Cureus.

[4]  J. Zamorano,et al.  Feasibility and Reproducibility of Left Atrium Measurements Using Different Three-Dimensional Echocardiographic Modalities , 2020, Diagnostics.

[5]  Jian Liu,et al.  Real-time three-dimensional echocardiography predicts cardiotoxicity induced by postoperative chemotherapy in breast cancer patients , 2020, World journal of clinical cases.

[6]  P. Hantson.  Mechanisms of toxic cardiomyopathy , 2018, Clinical toxicology.

[7]  S. Matoba,et al.  Impact of Left Ventricular Diastolic Property on Left Atrial Function from Simultaneous Left Atrial and Ventricular Three-Dimensional Echocardiographic Volume Measurement. , 2017, The American journal of cardiology.

[8]  L. Sade.  Speckle tracking strain imaging: Practical approach for application. , 2017, Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir.

[9]  D. Yellon,et al.  Anthracycline Chemotherapy and Cardiotoxicity , 2017, Cardiovascular Drugs and Therapy.

[10]  Jeroen J. Bax,et al.  2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines , 2016, European journal of heart failure.

[11]  Li-qun Ren,et al.  Serum B-type natriuretic peptide levels as a marker for anthracycline-induced cardiotoxicity. , 2016, Oncology letters.

[12]  E. Sadurska.  Current Views on Anthracycline Cardiotoxicity in Childhood Cancer Survivors , 2015, Pediatric Cardiology.

[13]  V. Agrawal,et al.  Use of biomarkers for the assessment of chemotherapy-induced cardiac toxicity. , 2015, Clinical biochemistry.

[14]  H. Miyoshi,et al.  Association of left atrial reservoir function with left atrial structural remodeling related to left ventricular dysfunction in asymptomatic patients with hypertension: evaluation by two-dimensional speckle-tracking echocardiography , 2015, Clinical and experimental hypertension.

[15]  M. Cerqueira,et al.  Expert consensus for multimodality imaging evaluation of adult patients during and after cancer therapy: a report from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. , 2014, European heart journal cardiovascular Imaging.

[16]  P. Vejpongsa,et al.  Prevention of anthracycline-induced cardiotoxicity: challenges and opportunities. , 2014, Journal of the American College of Cardiology.

[17]  N. Ozdemir,et al.  Left atrial expansion index is an independent predictor of diastolic dysfunction in patients with preserved left ventricular systolic function: a three dimensional echocardiography study , 2014, The International Journal of Cardiovascular Imaging.

[18]  Petr Otahal,et al.  Prognostic implications of global LV dysfunction: a systematic review and meta-analysis of global longitudinal strain and ejection fraction , 2014, Heart.

[19]  M. Zugaib,et al.  Cord blood B-type natriuretic peptide levels in placental insufficiency: correlation with fetal Doppler and pH at birth. , 2013, European journal of obstetrics, gynecology, and reproductive biology.

[20]  A. Ribeiro,et al.  The impact of right ventricular stroke work on B-type natriuretic peptide levels in patients with mitral stenosis undergoing percutaneous mitral valvuloplasty. , 2013, Journal of interventional cardiology.

[21]  M. Maeder.  Ultrasensitive cardiac troponin and myocardial strain predict cardiotoxicity. , 2012, Biomarkers in medicine.

[22]  Randolph P. Martin,et al.  Assessment of Echocardiography and Biomarkers for the Extended Prediction of Cardiotoxicity in Patients Treated With Anthracyclines, Taxanes, and Trastuzumab , 2012, Circulation. Cardiovascular imaging.

[23]  S. Lipsitz,et al.  Changes in cardiac biomarkers during doxorubicin treatment of pediatric patients with high-risk acute lymphoblastic leukemia: associations with long-term echocardiographic outcomes. , 2012, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[24]  Randolph P. Martin,et al.  Early detection and prediction of cardiotoxicity in chemotherapy-treated patients. , 2011, The American journal of cardiology.

[25]  N. Ohte,et al.  Correlation between left ventricular end-diastolic pressure and peak left atrial wall strain during left ventricular systole. , 2009, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[26]  B. Garibaldi,et al.  An Unusual Case of Cardiac Amyloidosis , 2007, Journal of General Internal Medicine.

[27]  P. Voûte,et al.  Frequency and risk factors of subclinical cardiotoxicity after anthracycline therapy in children: a systematic review. , 2002, Annals of oncology : official journal of the European Society for Medical Oncology.

[28]  J. Gibbs,et al.  Mitral regurgitation after anthracycline treatment for childhood malignancy , 2001, Heart.

[29]  D. V. Von Hoff,et al.  Risk factors for doxorubicin-induced congestive heart failure. , 1979, Annals of internal medicine.

[30]  E. Kleinerman,et al.  Anthracycline-Induced Cardiotoxicity: Causes, Mechanisms, and Prevention. , 2020, Advances in experimental medicine and biology.

[31]  G. Breithardt,et al.  Reduced repolarization reserve due to anthracycline therapy facilitates torsade de pointes induced by IKr blockers , 2006, Basic Research in Cardiology.