Characteristic of cardiovascular status and intracardiac hemodynamics in patients with multiple myeloma before the start of antitumor therapy
https://doi.org/10.18087/cardio.2022.2.n1868
Abstract
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: 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: 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: 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.
Keywords
About the Authors
S. A. KardanovaRussian Federation
N.V. Sklifosovskiy Institute of Clinical Medicine Chair of Hospital Therapy №1, postgraduate student
I. S. Ilgisonis
Russian Federation
N.V. Sklifosovskiy Institute of Clinical Medicine Chair of Hospital Therapy №1, Professor, Ph.D., SPIN-code: 6806-9299
V. I. Ershov
Russian Federation
N.V. Sklifosovskiy Institute of Clinical Medicine Chair of Hospital Therapy №1, Professor, Ph.D., SPIN-code: 5246-8163
E. V. Privalova
Russian Federation
N.V. Sklifosovskiy Institute of Clinical Medicine Chair of Hospital Therapy №1, Professor, Ph.D., AutorID: 601446
Yu. N. Belenkov
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
References
1. Federal State Statistics Service. Morbidity of the population by the main classes of diseases. Av. at: https://rosstat.gov.ru/folder/13721. 2020.
2. Zamorano JL, Lancellotti P, Rodriguez Muñoz D, Aboyans V, Asteggiano R, Galderisi M et al. 2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines: The Task Force for cancer treatments and cardiovascular toxicity of the European Society of Cardiology (ESC). European Heart Journal. 2016;37(36):2768–801. DOI: 10.1093/eurheartj/ehw211
3. Lyon AR, Dent S, Stanway S, Earl H, Brezden‐Masley C, Cohen‐Solal A et al. Baseline cardiovascular risk assessment in cancer patients scheduled to receive cardiotoxic cancer therapies: a position statement and new risk assessment tools from the Cardio-Oncology Study Group of the Heart Failure Association of the European Society of Cardiology in collaboration with the International Cardio-Oncology Society. European Journal of Heart Failure. 2020;22(11):1945–60. DOI: 10.1002/ejhf.1920
4. Poh C, Keegan T, Rosenberg AS. Second primary malignancies in multiple myeloma: A review. Blood Reviews. 2021;46:100757. DOI: 10.1016/j.blre.2020.100757
5. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA: A Cancer Journal for Clinicians. 2019;69(1):7–34. DOI: 10.3322/caac.21551
6. Raluy M, Ramagopalan S, Panjabi S, Lambrelli D. Epidemiology and Clinical Characteristics of Patients with Multiple Myeloma in the United Kingdom. Blood. 2014;124(21):2048. DOI: 10.1182/blood.V124.21.2048.2048
7. Vinogradova O.Yu., Ptushkin V.V., Chernikov M.V., Kochkareva Yu.B., Zherebtsova V.A. Epidemiology of multiple myeloma in city Moscow. Therapeutic Archive. 2019;91(7):83–92. DOI: 10.26442/00403 660.2019.07.000305
8. Kaprin A.D., Starinsky V.V., Petrova G.V. Malignant neoplasms in Russia in 2018 (morbidity and mortality). -M.: P.A. Herzen MSRI branch of the FSBI ‘‘NMIC of Radiology’’ MH RF;2019. - 250 p. ISBN 978-5-85502-251-3
9. Mendeleeva L.P., Votyakova O.M., Pokrovskaya O.S., Rekhtina I.G., Darskaya E.I., Galtseva I.V. et al. National clinical recommendations on diagnosis and treatment of multiple myeloma. Hematology and Transfusiology. 2016;61(1 Suppl 2):1–24. DOI: 10.18821/0234-5730-2016-61-1
10. Greipp PR, Miguel JS, Durie BGM, Crowley JJ, Barlogie B, Bladé J et al. International Staging System for Multiple Myeloma. Journal of Clinical Oncology. 2005;23(15):3412–20. DOI: 10.1200/JCO.2005.04.242
11. Durie BG, Salmon SE. A clinical staging system for multiple myeloma. Correlation of measured myeloma cell mass with presenting clinical features, response to treatment, and survival. Cancer. 1975;36(3):842–54. DOI: 10.1002/1097-0142(197509)36:3<842:aid-cncr2820360303>3.0.co;2-u
12. Cesari M, Pahor M, Incalzi RA. Plasminogen Activator Inhibitor-1 (PAI-1): A Key Factor Linking Fibrinolysis and Age-Related Subclinical and Clinical Conditions. Cardiovascular Therapeutics. 2010;28(5):e72–91. DOI: 10.1111/j.1755-5922.2010.00171.x
13. Kazandjian D. Multiple myeloma epidemiology and survival: A unique malignancy. Seminars in Oncology. 2016;43(6):676–81. DOI: 10.1053/j.seminoncol.2016.11.004
14. Li W, Garcia D, Cornell RF, Gailani D, Laubach J, Maglio ME et al. Cardiovascular and Thrombotic Complications of Novel Multiple Myeloma Therapies: A Review. JAMA Oncology. 2017;3(7):980–8. DOI: 10.1001/jamaoncol.2016.3350
15. Averkov O.V., Duplyakov D.V., Gilyarov M.Yu., Novikova N.A., Shakhnovich R.M., Yakovlev A.N. et al. 2020 Clinical practice guidelines for Acute ST-segment elevation myocardial infarction. Russian Journal of Cardiology. 2020;25(11):251–310. DOI: 10.15829/29/1560-4071-2020-4103
16. Wong BW, Meredith A, Lin D, McManus BM. The Biological Role of Inflammation in Atherosclerosis. Canadian Journal of Cardiology. 2012;28(6):631–41. DOI: 10.1016/j.cjca.2012.06.023
17. Meuwissen M. Colocalisation of intraplaque C reactive protein, complement, oxidised low density lipoprotein, and macrophages in stable and unstable angina and acute myocardial infarction. Journal of Clinical Pathology. 2006;59(2):196–201. DOI: 10.1136/jcp.2005.027235
18. Galkina E, Ley K. Immune and Inflammatory Mechanisms of Atherosclerosis. Annual Review of Immunology. 2009;27(1):165–97. DOI: 10.1146/annurev.immunol.021908.132620
19. Hudzik B, Szkodzinski J, Romanowski W, Danikiewicz A, Wilczek K, Lekston A et al. Serum interleukin-6 concentration reflects the extent of asymptomatic left ventricular dysfunction and predicts progression to heart failure in patients with stable coronary artery disease. Cytokine. 2011;54(3):266–71. DOI: 10.1016/j.cyto.2011.02.012
20. Gupta J, Dominic EA, Fink JC, Ojo AO, Barrows IR, Reilly MP et al. Association between Inflammation and Cardiac Geometry in Chronic Kidney Disease: Findings from the CRIC Study. PLOS ONE. 2015;10(4):e0124772. DOI: 10.1371/journal.pone.0124772
21. Fontes JA, Rose NR, Čiháková D. The varying faces of IL-6: From cardiac protection to cardiac failure. Cytokine. 2015;74(1):62–8. DOI: 10.1016/j.cyto.2014.12.024
22. Wang X, Guo Z, Zhu Z, Bao Y, Yang B. Epicardial fat tissue in patients with psoriasis:a systematic review and meta-analysis. Lipids in Health and Disease. 2016;15(1):103. DOI: 10.1186/s12944-016-0271-y
23. Chen WJY, Danad I, Raijmakers PG, Halbmeijer R, Harms HJ, Lammertsma AA et al. Effect of Type 2 Diabetes Mellitus on Epicardial Adipose Tissue Volume and Coronary Vasomotor Function. The American Journal of Cardiology. 2014;113(1):90–7. DOI: 10.1016/j.amjcard.2013.09.022
24. Packer M. Characterization, Pathogenesis, and Clinical Implications of Inflammation‐Related Atrial Myopathy as an Important Cause of Atrial Fibrillation. Journal of the American Heart Association. 2020;9(7):e015343. DOI: 10.1161/JAHA.119.015343
25. Vora PA, Patel R, Dharamsi A. Bortezomib – First Therapeutic Proteasome Inhibitor for Cancer Therapy: A Review of Patent Literature. Recent Patents on Anti-Cancer Drug Discovery. 2020;15(2):113–31. DOI: 10.2174/1574892815666200401113805
26. Minnie SA, Hill GR. Immunotherapy of multiple myeloma. Journal of Clinical Investigation. 2020;130(4):1565–75. DOI: 10.1172/JCI129205
27. Cole DC, Frishman WH. Cardiovascular Complications of Proteasome Inhibitors Used in Multiple Myeloma. Cardiology in Review. 2018;26(3):122–9. DOI: 10.1097/CRD.0000000000000183
Review
For citations:
Kardanova S.A., Ilgisonis I.S., Ershov V.I., Privalova E.V., Belenkov Yu.N. Characteristic of cardiovascular status and intracardiac hemodynamics in patients with multiple myeloma before the start of antitumor therapy. Kardiologiia. 2022;62(2):4-11. https://doi.org/10.18087/cardio.2022.2.n1868