Abstract 11384: Evaluation of Left Ventricular Systolic Function by Magnetic Resonance Imaging in Patients with Multiple Myeloma and Cardiac Amyloidosis Receiving Autologous Bone Marrow Transplantation
BACKGROUND/AIMS: Cardiac MRI has evolved as a sensitive imaging technique for detecting cardiac amyloidosis as well as left ventricular (LV) function. We assessed LV systolic function in patients with multiple myeloma and cardiac amyloidosis undergoing bone marrow transplantation. Further, we examined if plasma levels of certain immune markers would correlate with change in EF following bone marrow transplant.
METHODS: LV function was assessed before and after (within 6-12 months of) autologous bone marrow transplantation in 17 patients with multiple myeloma and cardiac amyloidosis using Cardiac MRI . Normal LV function was categorized as EF >55%. Patients who had post-transplant change in LV systolic function were further studied for association with the level of immune prognostic markers CD-4, CD-19, CRP and IL-6.
RESULTS: Ten of 17 patients (59%) had normal LV EF before transplant . In eight of these patients the EF remained normal while in two patients EF slightly decreased post-transplant. In 7/17 patients (41%), pre-transplant EF was low; LV EF improved in each of these 7 of these patients (from 46±7 to 55±10%, P<0.01) . There was no significant association of pre-transplant plasma levels of CD-4, CD-19, CRP and IL-6 with change in LV EF.
CONCLUSIONS: This study shows that LV EF improves to normal or near-normal levels in almost 80% of patients with multiple myeloma within 6-12 months of bone marrow transplant. These patients are characterized by low EF pre-transplant, indicating homing of stem cells in the failing regions of the heart. However, plasma levels of immune markers CD-4, CD-19, CRP and IL-6 do not predict patients likely to have low EF or their subsequent improvement post-bone marrow transplant.
- © 2011 by American Heart Association, Inc.