title: Risk factors affecting cardiac left-ventricular hypertrophy and systolic and diastolic function in the chronic phase of allogeneic hematopoietic cell transplantation.
abstract: Chronic impairment of cardiac function can be an important health risk and impair the quality of life, and may even be life-threatening for long-term survivors of allogeneic hematopoietic cell transplantation (HCT). However, risk factors for and/or the underlying mechanism of cardiac dysfunction in the chronic phase of HCT are still not fully understood. We retrospectively investigated factors affecting cardiac function and left-ventricular hypertrophy (LVH) in the chronic phase of HCT. Sixty-three recipients who survived for >1 year after receiving HCT were evaluated using echocardiography. Based on simple linear regression models, high-dose TBI-based conditioning was significantly associated with a decrease in left-ventricular ejection fraction and the early peak flow velocity/atrial peak flow velocity ratio, following HCT (coefficient=-5.550, P=0.02 and coefficient=-0.268, P=0.02, respectively). These associations remained significant with the use of multiple linear regression models. Additionally, the serum ferritin (s-ferritin) level before HCT was found to be a significant risk factor for LVH on multivariable logistic analysis (P=0.03). In conclusion, our study demonstrated that a myeloablative regimen, especially one that involved high-dose TBI, impaired cardiac function, and that a high s-ferritin level might be associated with the development of LVH in the chronic phase of HCT.
authors.affiliation: Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Nishimoto
authors.forename: H
authors.initials: H
authors.lastname: Nakamae
authors.forename: H
authors.initials: H
authors.lastname: Koh
authors.forename: T
authors.initials: T
authors.lastname: Nakane
authors.forename: M
authors.initials: M
authors.lastname: Nakamae
authors.forename: A
authors.initials: A
authors.lastname: Hirose
authors.forename: K
authors.initials: K
authors.lastname: Hagihara
authors.forename: Y
authors.initials: Y
authors.lastname: Nakao
authors.forename: Y
authors.initials: Y
authors.lastname: Terada
authors.forename: M
authors.initials: M
authors.lastname: Ohsawa
authors.forename: M
authors.initials: M
authors.lastname: Hino
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D004452:Echocardiography; D005260:Female; D019337:Hematologic Neoplasms / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D019172:Transplantation Conditioning / Q000009:adverse effects*; D014184:Transplantation, Homologous; D016277:Ventricular Function, Left