cardioКардиологияKardiologiia0022-90402412-5660Kardiomag10.18087/cardio.2022.2.n1868cardio-1868Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИRESEARCH ARTICLESОсобенности сердечно-сосудистого статуса и внутрисердечной гемодинамики у больных множественной миеломой до начала противоопухолевой терапииCharacteristic of cardiovascular status and intracardiac hemodynamics in patients with multiple myeloma before the start of antitumor therapyhttps://orcid.org/0000-0002-4220-7582КардановаС. А.KardanovaS. A.

Аспирант кафедры Госпитальной терапии № 1 ИКМ им. Н.В. Склифосовского Первого МГМУ им. И.М Сеченова 

N.V. Sklifosovskiy Institute of Clinical Medicine Chair of Hospital Therapy №1, postgraduate student

scardanova@yandex.ruhttps://orcid.org/0000-0001-6817-6270ИльгисонисИ. С.IlgisonisI. S.

Профессор кафедры Госпитальной терапии № 1 ИКМ им. Н.В. Склифосовского, к.м.н.

N.V. Sklifosovskiy Institute of Clinical Medicine Chair of Hospital Therapy №1, Professor, Ph.D., SPIN-code: 6806-9299

ichekneva@yandex.ruhttps://orcid.org/0000-0002-8641-1489ЕршовВ. И.ErshovV. I.

Профессор кафедры Госпитальной терапии № 1 ИКМ им. Н.В. Склифосовского, д.м.н.

N.V. Sklifosovskiy Institute of Clinical Medicine Chair of Hospital Therapy №1, Professor, Ph.D., SPIN-code: 5246-8163

ershov-1943@mail.ruhttps://orcid.org/0000-0001-6675-7557ПриваловаЕ. В.PrivalovaE. V.

Профессор кафедры Госпитальной терапии № 1 ИКМ им. Н.В. Склифосовского, д.м.н.

N.V. Sklifosovskiy Institute of Clinical Medicine Chair of Hospital Therapy №1, Professor, Ph.D., AutorID: 601446

ev_privalova@mail.ruhttps://orcid.org/0000-0002-3014-6129БеленковЮ. Н.BelenkovYu. N.

Академик РАН, заведующий кафедрой Госпитальной терапии № 1 ИКМ им. Н.В. Склифосовского, профессор, д.м.н.

N.V. Sklifosovskiy Institute of Clinical Medicine Chair of Hospital Therapy №1, Professor, Ph.D., Head of Department, Academician of the Russian Academy of Sciences, AutorID: 80533

ynbelenkov@gmail.ruФГАОУ ВО Первый Московский государственный медицинский университет им. И.М. Сеченова Минздрава России (Сеченовский Университет), МоскваРоссияI.M.Sechenov First Moscow State Medical University (Sechenov University), MoscowRussian Federation202228022022622411Copyright © Kardiomag, 20222022KardiomagKardiomaghttps://cardio.elpub.ru/jour/about/submissions#copyrightNoticehttps://cardio.elpub.ru/jour/article/view/1868

Цель    Оценка факторов риска, сердечно-сосудистого статуса и состояния внутрисердечной гемодинамики у пациентов с множественной миеломой (ММ) до начала специфической противоопухолевой терапии.

Материал и методы  В исследование включены 2 равных по числу группы пациентов: 1‑я группа – 25 пациентов с впервые установленным диагнозом ММ, 2‑я группа (группа сравнения) – 25 пациентов с доказанными сердечно-сосудистыми заболеваниями (ССЗ): гипертоническая болезнь (ГБ) и ишемическая болезнь сердца (ИБС). Всем пациентам, включенным в исследование, проведены стандартная лабораторная диагностика, инструментальные исследования (электрокардиография, эхокардио­графия, суточное мониторирование электрокардиограммы по Холтеру); проанализированы доказанные факторы риска развития ССЗ.

Результаты   При сравнении двух групп достоверно показано, что состояние сердечно-сосудистой системы (ССС) у пациентов с ММ сопоставимо с таковым у пациентов с доказанными ССЗ. У пациентов из основной группы выявлены достоверные положительные корреляции средней силы между показателями системного воспаления, липидного состава крови и внутрисердечной гемодинамики: уровней С-реактивного белка (СРБ) и триглицеридов (r=0,415; p<0,05); уровней СРБ и липопротеидов очень низкой плотности (r=0,345; p=0,09); уровня СРБ и объема левого предсердия (r=0,434; p<0,05); уровня СРБ и конечного диастолического объема (r=0,30; p<0,05). Исходно высокий риск развития сердечно-сосудистых осложнений у пациентов с ММ может быть обусловлен ремоделированием сердца, ассоциированным с активностью системного воспаления.

Заключение     С учетом использования потенциально кардиоваскулотоксичных препаратов для лечения множественной миеломы, оценка сердечно-сосудистого статуса и консультация кардиоонколога / кардио­лога с подбором необходимой терапии должны быть обязательным этапом до начала специфического лечения.

 

Aim

Aim: assessment of risk factors, cardiovascular status and intracardiac hemodynamics in patients with multiple myeloma before the start of specific antitumor therapy.

 

 

Materials and methods

Materials and methods: The study included 2 equal groups of patients: the first group – 25 patients with a newly diagnosed diagnosis of multiple myeloma (MM), the comparison group – 25 patients with proven cardiovascular diseases (CVD) (hypertension (HD) and coronary heart disease (CHD)). All patients included in the study underwent standard laboratory diagnostics, instrumental research methods (ECG, Echo-KG, 24-hour Holter monitoring); proven CVD risk factors were also evaluated.

 

 

Results

Results: When comparing the two groups, it was reliably shown that the state of CVD in patients with MM is comparable to that in patients with proven CVD. In patients from the main group, were revealed significant positive correlations of average strength between indicators of systemic inflammation, the lipid spectrum and intracardiac hemodynamics: between the levels of CRP and triglycerides (r=0,415, p<0,05); between the values of CRP and LDL (r=0,345, p=0,09); CRP and LA volume (r=0,434, p<0,05); CRP and final diastolic volume (r=0,30, p<0,05). At the beginning, a high risk of developing CV- events in patients with MM may be due to cardiac remodeling associated with the activity of systemic inflammation.

Conclusion

Conclusion: in view the use of potentially cardiovasculartoxicity drugs for the treatment of multiple myeloma, the assessment of the CV status and consultation with a cardiologist/cardiologist with the selection of the necessary therapy should be obligatory step before starting specific treatment.

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The authors declare that there are no conflicts of interest present.