Right Ventricular Functional Changes in Patients Undergoing Bone Marrow Transplantation: An Advanced Echocardiographic Analysis

OBJECTIVE: This study aimed to evaluate right ventricular (RV) function pre and post bone marrow transplantation (BMT) using transthoracic echocardiography (TTE), in order to detect subclinical or clinical RV dysfunction that may occur in the early posttransplant period due to pulmonary vascular changes. METHODS: A total of 45 patients (aged 18-65 years) who underwent allogeneic or autologous BMT and 45 age- and sex-matched healthy controls were prospectively enrolled. Baseline (pre-BMT) and first-month (post-BMT) data of both groups were compared. Sociodemographic characteristics, laboratory results, and echocardiographic parameters were analyzed. RESULTS: In the BMT group, RV global longitudinal strain (RVGLS) (-19.24 ± 8.71 vs. -22.33 ± 1.64; p = 0.022) and RV free wall strain (RVFWS) (-25.96 ± 2.83 vs. -28.21 ± 2.10; p < 0.001) were significantly lower than in controls. Four-dimensional echocardiography (4DE) demonstrated lower RV ejection fraction (RVEF) (52.31 ± 2.46 vs. 56.60 ± 5.55; p < 0.001) and RV fractional area change (RVFAC) (46.27 ± 2.57 vs. 51.42 ± 4.56; p < 0.001) in the BMT group compared to controls. Although pulmonary artery stiffness (PAS) (17.09 ± 4.24 vs. 18.56 ± 4.06 Hz/ms; p = 0.098) was higher in the BMT group, the difference did not reach statistical significance. CONCLUSION: This study indicates that BMT may adversely affect RV systolic and diastolic functions as well as pulmonery artery stiffness (PAS). Advanced echocardiographic assessment in patients at risk of cardiotoxicity during the pre- and posttransplant period may facilitate early detection and implementation of preventive and therapeutic strategies.