Abstract 20407: Acute Leukemia is Associated With Cardiac Dysfunction Before Chemotherapy
Background: Patients with acute leukemia (AL) develop a higher rate of congestive heart failure than patients with other cancers. Acute leukemia may predispose to cardiac dysfunction prior to chemotherapy due to high cytokine release or direct leukemic cells infiltration of the heart. The aim of this study was to evaluate whether AL is associated with left ventricular (LV) dysfunction before chemotherapy.
Methods: Seventy six patients with AL and 76 patients without cancer with no known cardiomyopathy or valvular heart disease were matched for age, gender, hypertension and presence of diabetes. Subsequently, 28 women in each group were matched (1:1:1) with women with breast cancer (to assess the effect of a non hematological malignancy). LV mass, volumes, ejection fraction (EF) and global longitudinal strain (GLS -Tomtec Imaging System) were measured before chemotherapy.
Results: The baseline characteristics of the patients are summarized in the Table. Despite similar LV ejection fraction (63±5% vs. 62±6%, P=0.34), the 76 AL patients had significantly higher LV mass and volumes and significantly lower GLS (-19±3% vs -21±2%, P<0.001) than controls. Similarly, GLS was lower in 28 females with AL than in 28 women with breast cancer (-19.4 ±3.0% vs -21.2 ±2.2%, P=0.023) or without cancer (-21.5±2.1%, P<0.008). There was no difference between the GLS of women with breast cancer or without cancer (P=0.9). Among patients with AL, the factors independently associated with GLS were BMI (beta= -0.14, P=0.008), LVEF (beta= 0.10, P= 0.042) and absolute lymphocyte count (beta= 0.15, P=0.003).
Conclusion: GLS before chemotherapy was decreased in AL patients compared to matched breast cancer and non-cancer patients, suggesting that AL by itself is associated with myocardial dysfunction.
Author Disclosures: B.M. Assuncao: None. T.C. Tan: None. K. Cheng: None. E. Yucel: None. M.D. Handschumacher: None. M. Scherrer-Crosbie: None.
- © 2016 by American Heart Association, Inc.