Abstract
Objective: The aim of this study was to investigate left ventricular (LV) function and correlate with cardiovascular risk factors in patients with leukemia before chemotherapy using conventional 2-dimensional (2D), pulsed tissue Doppler (PTD) and two-dimensional longitudinal strain echocardiography (2-DST). Design and method: We enrolled 20 patients diagnosed with leukemia aged 33–79 years evaluated for chemotherapy compared with 10 healthy control patients. Systolic (SBP) and diastolic blood preasure (DBP), heart rate (HR), Body mass index (BMI) were measured and Hemoglobin (Hb), Hematocrit (Ht) were analyzed before chemotherapy. The echocardiography 2D,PTD,2-DST were performed prior to treatment and calculated Left Ventricular Ejection Fraction (LVEF), fractional shortening (FS), tissue Doppler peak mitral annulus systolic velocity (S), Mitral annular plane systolic excursion (MAPSE) and global systolic longitudinal myocardinal strain (GLS) and correlated with cardiovascular risk factors. Results: From all study patients, 8 (40%) are smokers and 4 (20%) with pathologic LVEF (%) < 50 before treatment. Hb (g/dl) was significantly decresed from 13.49 ± 1.21 to 8.49 ± 1.87 (p < 0.001) in study group than control. There was significant decrease in LVEF (%) and MAPSE (mm) from 63.10 ± 7.43 to 55.2 ± 6.22 respectively from 16.30 ± 2.45 to 12.70 ± 2.77 (p < 0.05).There was significant increase in FS (%) and S (mm/s) from 31.10 ± 4.50 to 40.61 ± 9.38 respectively from 0.09 ± 0.01 to 0.11 ± 0.03 (p < 0.05) and no significant difference in GLS, SBP, DBP. There were 9 (45%) patients with limfoblastic leukemia with LVEF (%) and MAPSE (mm) significantly decrease (p < 0.05) in study patients than control. There were 9 (45%) hypertension and 4 (13,3%) coronary patients with significantly decrease in LVEF (%) (p < 0.05) and slightly decrease values in GLS (%) than controls. GLS (%) slightly decrease and LVEF (%) significantly decrease (p < 0.05) in hypertension than smokers patients. Conclusions: In patients with leukemia LV function should be assessed at baseline with 2D, PTD and 2-DST echocardiography before starting chemotherapy and repeat assessments during and after treatment, should also be considered. Combining 2D, PTD and 2-DST echocardiography can give complementary results in detecting LV disfunction before clinical signs. At the beginning of chemotherapy should be given special attention to patients with cardiovascular risk factors.
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