Investigation of Subclinical Cardiotoxicity in Chronic Leukemia Patients with Non-invasive Tests

Abstract

Introduction:This study aimed to investigate the left ventricular function and electrocardiographic findings in patients with chronic leukemia receiving and not receiving chemotherapy during a one-year follow-up.Methods:A total of 111 patients with chronic leukemia were included in the study. Electrocardiographic and mechanical findings of the heart were evaluated by surface 12-lead electrocardiogram and 2-dimensional transthoracic echocardiography, and cardiac troponin (cTn) was evaluated for myocyte damage and B-type natriuretic peptide marker for heart failure at baseline, 6th month and 12th month.Results:During the study, a total of six patients reached the endpoint, including two patients to primary endpoint (atrial fibrillation) and four patients to secondary endpoint (non-cardiac death). However, asymptomatic hemodynamic and electrocardiographic changes were observed in all patients who did not reach the endpoint. There was a quantitative decrease in left ventricular ejection fraction and an increase in the rate of diastolic dysfunction. Increased incidence of fragmented QRS, and prolongation of QT interval and QT dispersion, which are important indicators of possible cardiac events, were detected. cTn levels were observed to be at the upper limit of the normal range. All these findings show that myocardial damage has begun in the study patients, even if it is asymptomatic.Conclusion:In order to prevent future cardiac events in this patient group, these changes need to be taken into consideration and closely monitored.

Keywords

• chronic leukemia
• heart failure
• cardiotoxicity