Vascular Health and Risk Management (Feb 2022)
Comparative Assessment of Echocardiographic Patterns Among Chronic Myeloid Leukemia Patients on Tyrosine Kinase Inhibitor and Healthy Controls
Abstract
Abayomi O Bamgboje,1 Muheez A Durosinmi,2 Tuoyo O Mene-Afejuku,3 Micheal O Fagbayimu,4 Olusola Fajobi,5 Michael O Balogun6 1Department of Internal Medicine, SCL Healthcare St Vincent’s/Holy Rosary Hospital, Miles city, Montana, 59101, USA; 2Department of Hematology and Immunology Obafemi Awolowo University Teaching Hospitals Complex Ile-Ife, Osun state, Nigeria; 3Department of Cardiology Tower Health System, Reading Hospital, West Reading, Pennsylvania, USA; 4Department of Surgery Obafemi Awolowo University Teaching Hospitals Complex Ile-Ife, Osun State, Nigeria; 5Department of Community Medicine Awolowo University Teaching Hospitals Complex Ile-Ife, Osun State, Nigeria; 6Department of Internal Medicine Cardiology Unit Obafemi Awolowo University Teaching Hospitals Complex Ile-Ife, Osun State, NigeriaCorrespondence: Abayomi O Bamgboje, Department of Internal Medicine, 1233 North 30th Street, Billings, MT, 59101, USA, Tel +1 9293189246, Email [email protected]: Chronic myeloid leukemia (CML) is one of the common hematological malignancies in Nigeria. Cardiac abnormalities are associated with CML irrespective of treatment with tyrosine kinase inhibitors such as imatinib, which is available gratis in Nigeria.Objective: To assess the prevalence and patterns of cardiac dysfunction among patients with CML irrespective of treatment with imatinib using transthoracic echocardiography, and 12-lead surface electrocardiography.Patients and Methods: CML patients without Imatinib, CML patients with imatinib, and apparently healthy (age- and sex-matched) controls were 70 each in the study. Various echocardiographic parameters were measured and data obtained were analyzed, and the level of significance was taken as p < 0.05.Results: Of 70 CML patients with imatinib, 54.3% were men and 45.7% were women, while the CML group without imatinib had 62.9% men and 37.1% women, non-CML control had 54.3% men and 45.7% women. The average hematocrit was significantly lower in the CML group without Imatinib compared with the other groups (p< 0.001). And, 12.9% and 17.1% of CML groups with and without imatinib had LVH, respectively, and none of the non-CML controls had LVH (P< 0.041). Impaired left ventricular relaxation in 25.71% and 28.57% of CML patients with and without imatinib respectively but only 8.57% of the non-CML control had impaired left ventricular relaxation (p=0.236). Mitral valve regurgitation was the most frequent valvular abnormality across the groups. Pulmonary hypertension in 17.4% and 20% of CML patients with and without imatinib, respectively, but none of the non-CML controls had pulmonary hypertension (p< 0.001). Pericardial effusion in 32.86% and 45.71% of CML patients with and without imatinib, respectively, but none of the non-CML controls had pericardial effusion (p< 0.001). There was no significant difference in the QTC interval across the three groups.Conclusion: Cardiac abnormalities are present in CML patients with or without Imatinib treatment, with significant prevalence than what is seen in the non-CML control group.Keywords: chronic myeloid leukemia, CML, tyrosine kinase inhibitor-imatinib, cardiac dysfunction
