Antitumor treatment and cardiohemodynamics in patients with multiple myeloma depending on renal function

Authors

  • B. B. Samura Zaporizhzhia State Medical University, Ukraine,
  • M. O. Panasenko Zaporizhzhia State Medical University, Ukraine,

DOI:

https://doi.org/10.14739/2409-2932.2020.2.207199

Keywords:

cardiohemodynamics, multiple myeloma, renal function, antitumor treatment

Abstract

 

Purpose – to evaluate the relations of antitumor treatment and cardiohemodynamics in patients with multiple myeloma depending on renal function.

Materials and methods. Fifty-one subjects with multiple myeloma were enrolled in the study. They were divided into groups depending on the glomerular filtration rate (GFR). First group involved 12 patients with GFR 30–59 ml/min/1,73 m2, second one – 14 patients with GFR 60–89 ml/min/1,73m2, third one – 25 patients with normal renal function. All patients underwent echocardiography before and after antitumor treatment.

Results. In patients with GFR 30–59 ml/min/1.73 m2 ejection fraction was significantly lower in comparing with healthy persons (54.70 [51.20; 57.60] % versus 59.82 [57.81; 62.29] %; P = 0.012) mainly due to decreased end systolic volume (ESV) (55.90 [43.28; 59.39] ml versus 34,22 [31.72; 41.24] ml; P = 0.031). In this group ESV was significantly lower in comparing with patients with normal renal function. In patients with GFR 30–59 ml/min/1.73 m2 after antitumor treatment E (0.77 [0.59; 0.81] m/c, E/A (0.91 [0.86; 0.95] m/c were significantly lower in comparing with dates before treatment (P < 0.05). In patients with GFR ≥90 ml/min/1,73 m2 after antitumor treatment E/A (0.89 [0.72; 1.11] m/c were significantly lower in comparing with dates before treatment (P < 0.05).

In patients with GFR 30–59 ml/min/1.73 m2 E (0.89 [0.75; 1.00] m/s versus 1.01 [1.02; 1.24]; P = 0.014), A (0.89 [0.77; 1.10] m/s versus 0.73 [0.56; 0.85] м/s; P = 0.020). E/A (0.98 [0.94;1.12] versus 1.16 [1.06; 1.25]; P = 0.011) were significantly lower in in comparing with control.

Global circular systolic strain (-17.60 [-21.05; -15.18] versus -25.92 [-26.09; -19.15]; P = 0.012) and global circular systolic strain rate (-1.22 [-1.32; -1.20] versus -1.32 [-1.42; ‑1.25]; P = 0.022) was significantly lower in group of patients with GFR 30–59 ml/min/1.73 m2 in comparing with healthy persons.

Conclusions. Our data suggest that the extent of renal function is directly associated with left ventricle diastolic and regional systolic parameters. Among patients with multiple myeloma and renal insufficiency systolic, diastolic, and regional systolic contractility were significantly worse in comparing with patients with normal renal function and healthy persons. Antitumor treatment of multiple myeloma has a negative effect on diastolic and regional systolic function. These dates may be used for the prognosis of cardiovascular events.

 

References

Cowan, A. J., Allen, C., Barac, A., Basaleem, H., Bensenor, I., Curado, M. P., … Fitzmaurice, C. (2018). Global Burden of Multiple Myeloma ASystematic Analysis for the Global Burden of Disease Study 2016. Jama Oncology, 4(9), 1221-1227. https://doi.org/10.1001/jamaoncol.2018.2128

De Stefano, V., Za, T., & Rossi, E. (2014). Venous Thromboembolism in Multiple Myeloma. Seminars in Thrombosis and Hemostasis, 40(3), 338-347. https://doi.org/10.1055/s-0034-1370793

Kuznetsova, L. P., & Panasenko, M. O. (2019). Komorbidna patolohiia u khvorykh na mnozhynnu miielomu [Comorbidities in patients with multiple myeloma]. Current issues in pharmacy and medicine: science and practice, (2), 222-227. https://doi.org/10.14739/2409-2932.2019.2.171245

Samura, B. B. (2015). Prognosticheskaya rol’ tsirkuliruyushchego galektina-3 u patsientov s mnozhestvennoi mielomoi v remissii [Predictive value of circulating galectin-3 in patients with multiple myeloma in remission]. Zaporozhye medical journal, (4), 11-16. https://doi.org/10.14739/2310-1210.2015.4.50298

Eleutherakis-Papaiakovou, V., Bamias, A., Gika, D., Simeonidis, A., Pouli, A., Anagnostopoulos, A., Michali, E., Economopoulos, T., Zervas, K., Dimopoulos, M. A., & Greek Myeloma Study Group (2007). Renal failure in multiple myeloma: incidence, correlations, and prognostic significance. Leukemia & lymphoma, 48(2), 337-341. https://doi.org/10.1080/10428190601126602

Dimopoulos, M. A., Kastritis, E., Rosinol, L., Bladé, J., & Ludwig, H. (2008). Pathogenesis and treatment of renal failure in multiple myeloma. Leukemia, 22(8), 1485-1493. https://doi.org/10.1038/leu.2008.131

Dimopoulos, M. A., Sonneveld, P., Leung, N., Merlini, G., Ludwig, H., Kastritis, E., Goldschmidt, H., Joshua, D., Orlowski, R. Z., Powles, R., Vesole, D. H., Garderet, L., Einsele, H., Palumbo, A., Cavo, M., Richardson, P. G., Moreau, P., San Miguel, J., Rajkumar, S. V., Durie, B. G., … Terpos, E. (2016). International Myeloma Working Group Recommendations for the Diagnosis and Management of Myeloma-Related Renal Impairment. Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 34(13), 1544-1557. https://doi.org/10.1200/JCO.2015.65.0044

Ministry of Health of Ukraine. (2015, November 2). Unifikovanyi klinichnyi protokol pervynnoi, vtorynnoi (spetsializovanoi), tretynnoi (vysokospetsializovanoi) medychnoi dopomohy. Mnozhynna miieloma : Nakaz MOZ Ukrainy 02.11.2015 No. 710 [Unified clinical protocol of primary, secondary (specialized), tertiary (highly specialized) medical care. Multiple myeloma (No. 710)]. https://dec.gov.ua/wp-content/uploads/images/dodatki/2015_710_MM/2015_710_YKPMD_MM.pdf

Flakskampf, F. A. (Ed.). (2013). Prakticheskaya ekhokardiografiya : rukovodstvo po ekhokardiograficheskoi diagnostike [Practical echocardiography]. Moscow : MEDpress-inform. [in Russian].

Lapach, S. N., Chubenko, A. V., & Babich, P. N. (2002). Statistika v nauke i biznese [Statistics in science and business]. Kiev: Morion. [in Russian].

Gavriatopoulou, M., Musto, P., Caers, J., Merlini, G., Kastritis, E., van de Donk, N., Gay, F., Hegenbart, U., Hajek, R., Zweegman, S., Bruno, B., Straka, C., Dimopoulos, M. A., Einsele, H., Boccadoro, M., Sonneveld, P., Engelhardt, M., & Terpos, E. (2018). European myeloma network recommendations on diagnosis and management of patients with rare plasma cell dyscrasias. Leukemia, 32(9), 1883-1898. https://doi.org/10.1038/s41375-018-0209-7

How to Cite

1.
Samura BB, Panasenko MO. Antitumor treatment and cardiohemodynamics in patients with multiple myeloma depending on renal function. Current issues in pharmacy and medicine: science and practice [Internet]. 2020Jul.3 [cited 2024Nov.8];13(2). Available from: http://pharmed.zsmu.edu.ua/article/view/207199

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Section

Original research