Echocardiographic Assessment of Right Ventricular Function and Pulmonary Arterial Pressure in Patients with Multiple Myeloma Post Autologous Hematopoietic Stem Cell Transplantation

Background: Multiple myeloma [MM] is the second most common type of cancer affecting the blood and bone marrow. Autologous hematopoietic stem cell transplantation [auto-HSCT] has helped improve survival rates for multiple myeloma patients. However, the standard preparative regimen with melphalan can have cardiotoxic effects.The aim of the work: We aimed to investigate the potential utility of echocardiography in evaluating right ventricular [RV] function and estimating systolic pulmonary arterial pressure [sPAP] for the early detection of cardiotoxicity in multiple myeloma patients following auto-HSCT. The primary aim was to reduce cardiac morbidity and mortality and facilitate future preventive measures. Patients and Methods: This prospective study included data from 30 multiple myeloma patients planned to undergo auto-HSCT at the Cardiovascular Department of Sheikh Zayed Specialized Hospital in Giza, Egypt. Patients underwent echocardiographic assessment, including measurements of TAPSE, tricuspid annular S' velocity, FAC, and RIMP one day before and 30 days after conditioning with high dose melphalan.Results: Comparing pre- and post-auto-HSCT echocardiogram data, there were statistically significant drops in TAPSE, tricuspid annular S' velocity, FAC and a rise in RIMP post-transplant [P <0.001, P < 0.001, P = 0.009, P < 0.001 respectively].Conclusion: Early RV systolic dysfunction occurs post-auto-HSCT in multiple myeloma patients conditioned with high-dose melphalan.