Summed rest score in gated myocardial perfusion imaging is a good predicator for treatment-related cardiotoxicity after anthracycline chemotherapy in patients with diffuse large B-cell lymphoma

Yan Lin; Jianfeng Wang; Min Xu; Chun Qiu; Peng Xu; Limei Shang; Bai He; Fei Wang; Yanhua Yue; Yanting Guo; Feng Li; Weimin Dong; Xiaobao Xie; Yuetao Wang; Weiying Gu

doi:10.3892/ol.2020.12194

Summed rest score in gated myocardial perfusion imaging is a good predicator for treatment-related cardiotoxicity after anthracycline chemotherapy in patients with diffuse large B-cell lymphoma

Oncol Lett. 2020 Dec;20(6):330. doi: 10.3892/ol.2020.12194. Epub 2020 Oct 6.

Authors

Yan Lin¹, Jianfeng Wang², Min Xu³, Chun Qiu², Peng Xu¹, Limei Shang¹, Bai He¹, Fei Wang¹, Yanhua Yue¹, Yanting Guo¹, Feng Li¹, Weimin Dong¹, Xiaobao Xie¹, Yuetao Wang², Weiying Gu¹

Affiliations

¹ Department of Hematology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu 213003, P.R. China.
² Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu 213003, P.R. China.
³ Department of Echocardiography, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu 213003, P.R. China.

Abstract

Anthracycline chemotherapy is commonly used in the treatment of diffuse large B-cell lymphoma (DLBCL). Treatment-related cardiotoxicity (TRC) is defined as when the patient is identified to have one of the following clinical manifestations: Symptomatic heart failure, cardiac death, arrhythmia, infarction, a decrease in left ventricular ejection fraction (LVEF) of >15% from baseline or a decrease in LVEF of >10 to <50%. TRC may induce severe cardiac failure or cardiac arrhythmia as the main cause of death. The present study aimed to investigate the prognostic value of the summed rest score (SRS) in gated myocardial perfusion imaging (G-MPI) for the early detection of TRC caused by anthracycline chemotherapy in patients with DLBCL. A total of 36 DLBCL patients were enrolled in the present study, and a series of parameters were compared at baseline and after chemotherapy. According to the occurrence of TRC during the observation period, the patients were divided into two groups, and parameters associated with cardiac function were compared. The SRS in G-MPI and the corrected QT interval in the electrocardiogram were significantly different before and after chemotherapy (P=0.012 and P=0.015, respectively). By comparing parameters associated with cardiac function between the TRC group (n=22) and the no-TRC group (n=14), it was found that only SRS was significantly different (P=0.012). Multivariate logistic regression analysis showed that the SRS level was the only independent predicator for TRC (P=0.018; HR, 6.053; 95% CI, 1.364-26.869). Receiver operating characteristic curve analysis identified an optimal SRS cutoff of >1 for predicting TRC after anthracycline chemotherapy (P<0.001). Overall, the G-MPI SRS level was an early indicator for TRC surveillance in patients with DLBCL after anthracycline chemotherapy. The application of G-MPI SRS in clinical practice may contribute to early treatment and a subsequent decrease in mortality caused by such cardiovascular complications.

Keywords: diffuse large B-cell lymphoma; gated myocardial perfusion imaging; summed rest score; treatment-related cardiotoxicity.