Key result
Left ventricular systolic dysfunction measured by global longitudinal strain was significantly associated with reduced exercise capacity in long-term allo-HSCT survivors (AUC = 0.64, p = 0.014).
Why the study?
Exercise intolerance is common after allo-HSCT, but whether echocardiographic cardiac function is associated with exercise capacity in long-term survivors treated in youth was unknown.
Is left ventricular systolic dysfunction measured by echocardiography associated with reduced exercise capacity in long-term survivors of allo-HSCT?
Cross-Sectional (n=96)
Is left ventricular systolic dysfunction measured by echocardiography associated with reduced exercise capacity in long-term survivors of allo-HSCT?
Effect estimate: AUC 0.64
p-value: p=0.014
In long-term survivors of allo-HSCT, subclinical left ventricular systolic dysfunction measured by global longitudinal strain is independently associated with reduced exercise capacity.
GLS may aid risk stratification in allo-HSCT survivors; leaves open whether routine use improves outcomes.
Purpose Exercise intolerance is a common complication in survivors of allogeneic hematopoietic stem‐cell transplantation (allo‐HSCT). The aim of this study was to determine if cardiac function measured with echocardiography is associated with exercise capacity measured with cardio‐pulmonary exercise tests in long‐term survivors treated in their youth with allo‐HSCT. Methods The study included 96 patients, of which 54.2% were female, aged 34.9 ± 11.6 years and 17.7 ± 9.3 years after allo‐HSCT. Reduced exercise capacity was defined as <85% of predicted‐peak oxygen uptake (VO2peak). Linear regression was used in the prediction of VO2peak (ml/kg/min). Receiver operating characteristic evaluated the accuracy of predicting reduced exercise capacity. Results VO2peak was 36.2 ± 7.7 ml/kg/min and 43 (44.8%) had reduced exercise capacity. Left ventricular ejection fraction was 55.4 ± 5.9% and global longitudinal strain (GLS) was −17.6% ± 2.0%. Left and right ventricular functions were significantly lower in survivors with reduced exercise capacity. Increased body mass index, lower physical activity score, reduced pulmonary function (by forced expiratory volume in 1‐s) and reduced left ventricular systolic function (by GLS) were significant independent predictors for reduced VO2peak. GLS was superior to other echocardiographical indices for identifying reduced exercise capacity (area under curve = 0.64, p = 0.014). Conclusions Left ventricular systolic dysfunction measured by GLS is associated with reduced exercise capacity in long‐term allo‐HSCT survivors.
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Massey et al. (2022) conducted a cross-sectional in Allogeneic hematopoietic stem-cell transplantation survivors (n=96). Left ventricular systolic dysfunction (measured by global longitudinal strain) was evaluated on Reduced exercise capacity (<85% of predicted-peak oxygen uptake) (AUC 0.64, p=0.014). Left ventricular systolic dysfunction measured by global longitudinal strain was significantly associated with reduced exercise capacity in long-term allo-HSCT survivors (AUC = 0.64, p = 0.014).
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