Assessment of Specific Biomarkers' Profile and Structural, Functional Parameters of the Left Ventricle in Patients With Lymphomas Undergoing Antitumor Therapy.

IF 0.5 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Kardiologiya Pub Date : 2024-09-30 DOI:10.18087/cardio.2024.9.n2743

I Ya Sokolova, Sh M Murtuzaliev, S A Kardovskaya, A A Shchendrygina, P A Markin, S A Appolonova, T Yu Kulagina, O A Zhigulina, N V Khabarova, Yu N Belenkov, I S Ilgisonis

{"title":"Assessment of Specific Biomarkers' Profile and Structural, Functional Parameters of the Left Ventricle in Patients With Lymphomas Undergoing Antitumor Therapy.","authors":"I Ya Sokolova, Sh M Murtuzaliev, S A Kardovskaya, A A Shchendrygina, P A Markin, S A Appolonova, T Yu Kulagina, O A Zhigulina, N V Khabarova, Yu N Belenkov, I S Ilgisonis","doi":"10.18087/cardio.2024.9.n2743","DOIUrl":null,"url":null,"abstract":"Aim: To evaluate the dynamics of specific biomarkers for cardiotoxicity, endothelial dysfunction, fibrosis, systemic inflammation, and morpho-functional alterations in the left ventricular (LV) myocardium in patients with newly diagnosed lymphomas during 6 courses of polychemotherapy (PCT).Material and methods: The study included 30 patients with newly diagnosed lymphomas. All patients were evaluated for laboratory markers of cardiotoxicity at baseline and after 6 courses of chemotherapy (6 months), including N-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitivity troponin I (hsTnI), endothelin-1 (ET-1), circulating cardiac biomarker ST-2, high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), and LV structural and functional echocardiographic (EchoCG) parameters.Results: The changes in NT-proBNP and hsTnI concentrations during 6 courses of PCT were not statistically significant. Comparison of the baseline values with those after 6 courses of PCT showed increases in the median concentrations of ET-1 (3.38 and 5.5 pg/ml, respectively; p=0.438) and ST-2 (12.21 and 26.75 ng/ml, respectively; p=0.687). Markers of systemic inflammation were significantly decreased after 6 courses of PCT: the median CRP decreased from 15.2 to 0.72 mg/ml (p=0.006), and the median IL-6 decreased from 12.2 to 5.1 pg/ml (p=0.034). EchoCG data revealed a statistically significant impairment of the LV diastolic function parameters (E/A; E/e' lateral; E/e' average; left atrial volume index; isovolumic relaxation time). A moderate direct correlation was found between the ET-1 concentration and the isovolumic relaxation time at baseline and after 6 courses of PCT, respectively (r1 = 0.387, p=0.047 and r2 = 0.391, p=0.035). No changes in the LV systolic function were observed.Conclusion: The study showed that patients with lymphoproliferative diseases had no signs of cardiotoxicity during PCT according to the accepted criteria. This study described and highlighted for the first time the interrelation of endothelial dysfunction, profibrotic status, and LV diastolic dysfunction as manifestations of cardiovascular toxicity in patients with lymphoproliferative diseases. It is advisable to supplement the integrated strategies for the prevention and monitoring of PCT cardiovascular toxicity with a thorough evaluation of instrumental parameters of diastolic dysfunction for timely initiation/correction of cardioprotective therapy.","PeriodicalId":54750,"journal":{"name":"Kardiologiya","volume":"64 9","pages":"28-38"},"PeriodicalIF":0.5000,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Kardiologiya","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.18087/cardio.2024.9.n2743","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

Abstract

Aim: To evaluate the dynamics of specific biomarkers for cardiotoxicity, endothelial dysfunction, fibrosis, systemic inflammation, and morpho-functional alterations in the left ventricular (LV) myocardium in patients with newly diagnosed lymphomas during 6 courses of polychemotherapy (PCT).

Material and methods: The study included 30 patients with newly diagnosed lymphomas. All patients were evaluated for laboratory markers of cardiotoxicity at baseline and after 6 courses of chemotherapy (6 months), including N-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitivity troponin I (hsTnI), endothelin-1 (ET-1), circulating cardiac biomarker ST-2, high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), and LV structural and functional echocardiographic (EchoCG) parameters.

Results: The changes in NT-proBNP and hsTnI concentrations during 6 courses of PCT were not statistically significant. Comparison of the baseline values with those after 6 courses of PCT showed increases in the median concentrations of ET-1 (3.38 and 5.5 pg/ml, respectively; p=0.438) and ST-2 (12.21 and 26.75 ng/ml, respectively; p=0.687). Markers of systemic inflammation were significantly decreased after 6 courses of PCT: the median CRP decreased from 15.2 to 0.72 mg/ml (p=0.006), and the median IL-6 decreased from 12.2 to 5.1 pg/ml (p=0.034). EchoCG data revealed a statistically significant impairment of the LV diastolic function parameters (E/A; E/e' lateral; E/e' average; left atrial volume index; isovolumic relaxation time). A moderate direct correlation was found between the ET-1 concentration and the isovolumic relaxation time at baseline and after 6 courses of PCT, respectively (r1 = 0.387, p=0.047 and r2 = 0.391, p=0.035). No changes in the LV systolic function were observed.

Conclusion: The study showed that patients with lymphoproliferative diseases had no signs of cardiotoxicity during PCT according to the accepted criteria. This study described and highlighted for the first time the interrelation of endothelial dysfunction, profibrotic status, and LV diastolic dysfunction as manifestations of cardiovascular toxicity in patients with lymphoproliferative diseases. It is advisable to supplement the integrated strategies for the prevention and monitoring of PCT cardiovascular toxicity with a thorough evaluation of instrumental parameters of diastolic dysfunction for timely initiation/correction of cardioprotective therapy.

查看原文本刊更多论文

评估接受抗肿瘤治疗的淋巴瘤患者左心室的特定生物标记物特征及结构和功能参数

目的：评估新诊断的淋巴瘤患者在接受6个疗程的多化学疗法（PCT）期间，心脏毒性、内皮功能障碍、纤维化、全身炎症和左心室（LV）心肌形态功能改变的特定生物标志物的动态变化：研究对象包括30名新确诊的淋巴瘤患者。所有患者均在基线和 6 个疗程化疗（6 个月）后接受了心脏毒性实验室指标评估，包括 N 端前脑钠肽 (NT-proBNP)、高敏肌钙蛋白 I (hsTnI)、内皮素-1 (ET-1)、内皮素-1（ET-1）、循环心脏生物标志物 ST-2、高敏 C 反应蛋白（hsCRP）、白细胞介素-6（IL-6）以及左心室结构和功能超声心动图（EchoCG）参数。结果在 PCT 的 6 个疗程中，NT-proBNP 和 hsTnI 浓度的变化无统计学意义。将基线值与 PCT 6 个疗程后的值进行比较后发现，ET-1（分别为 3.38 和 5.5 pg/ml；p=0.438）和 ST-2 的中位浓度均有所增加（分别为 12.21 和 26.75 ng/ml；p=0.687）。经过 6 个疗程的 PCT 治疗后，全身炎症指标明显降低：CRP 中位数从 15.2 毫克/毫升降至 0.72 毫克/毫升（p=0.006），IL-6 中位数从 12.2 pg/ml 降至 5.1 pg/ml（p=0.034）。EchoCG 数据显示，左心室舒张功能参数（E/A；E/e'侧值；E/e'平均值；左心房容积指数；等容舒张时间）出现了统计学意义上的显著损伤。在基线和 6 个疗程的 PCT 治疗后，发现 ET-1 浓度与等容舒张时间之间分别存在中等程度的直接相关性（r1 = 0.387，p=0.047；r2 = 0.391，p=0.035）。左心室收缩功能未见变化：研究表明，根据公认的标准，淋巴细胞增生性疾病患者在 PCT 期间没有心脏毒性的迹象。本研究首次描述并强调了淋巴细胞增殖性疾病患者的内皮功能障碍、组织坏死状态和左心室舒张功能障碍作为心血管毒性表现的相互关系。在预防和监测 PCT 心血管毒性的综合策略中，最好对舒张功能障碍的仪器参数进行全面评估，以便及时启动/纠正心血管保护疗法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Kardiologiya 医学-心血管系统

CiteScore

1.70

自引率

20.00%

发文量

审稿时长

3-8 weeks

期刊介绍： “Kardiologiya” (Cardiology) is a monthly scientific, peer-reviewed journal committed to both basic cardiovascular medicine and practical aspects of cardiology. As the leader in its field, “Kardiologiya” provides original coverage of recent progress in cardiovascular medicine. We publish state-of-the-art articles integrating clinical and research activities in the fields of basic cardiovascular science and clinical cardiology, with a focus on emerging issues in cardiovascular disease. Our target audience spans a diversity of health care professionals and medical researchers working in cardiovascular medicine and related fields. The principal language of the Journal is Russian, an additional language – English (title, authors’ information, abstract, keywords). “Kardiologiya” is a peer-reviewed scientific journal. All articles are reviewed by scientists, who gained high international prestige in cardiovascular science and clinical cardiology. The Journal is currently cited and indexed in major Abstracting & Indexing databases: Web of Science, Medline and Scopus. The Journal''s primary objectives Contribute to raising the professional level of medical researchers, physicians and academic teachers. Present the results of current research and clinical observations, explore the effectiveness of drug and non-drug treatments of heart disease, inform about new diagnostic techniques; discuss current trends and new advancements in clinical cardiology, contribute to continuing medical education, inform readers about results of Russian and international scientific forums; Further improve the general quality of reviewing and editing of manuscripts submitted for publication; Provide the widest possible dissemination of the published articles, among the global scientific community; Extend distribution and indexing of scientific publications in major Abstracting & Indexing databases.