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CHOP chemotherapy (cyclophosphamide, doxorubicin, vincristin, prednisone) in non-Hodgkin lymphoma (NHL) has risk of cardiotoxicity, with increased mortality.

Aim: To define new parameters of 3D LV deformation, arterial stiffness and biomarkers, for early detection and prediction of cardiotoxicity.

Methods: 63 NHL patients (41men, 56±11years) with LVEF >50%, scheduled to receive CHOP, were assessed at baseline, after 6th cycle of CHOP and 6months after treatment completion (doxorubicin cumulative dose 356±73mg). 3D echo was used to assess LVEF and systolic deformation: longitudinal, radial, circumferential and area strain (LS, RS, CS, AS), Echo-Tracking for pulse wave velocity (PWV) and β index and troponin I and NTproBNP as markers of cardiac injury and high overload. Cardiotoxicity was defined as decrease LVEF<50%, with more than 10% from baseline.

Results: 6months after treatment completion, 14 patients (22%) (group I) developed cardiotoxicity (LVEF=61±2 vs 48±1, p<0.0001), while 49 patients (group II) did not (LVEF=62±1 vs 56±3, p<0.0001). There was a significant reduction of all LV deformation parameters and increased arterial stiffness starting with 6th cycle, but group I had greater changes than group II (p<0.001) (Table). There was a significant correlation between LVEF reduction and LS, CS, RS, AS decrease and increased PWV and β index and troponin level after 6th cycle (r=0.634; r=0.452; r=0.334; r=0.493; r=-0.451; r=-325; r=-0.311; all p<0.05). LS reduction after 6th cycle was the best independent predictor for LVEFdecrease after 6 months treatment completion (R2=0.421, p=0.001). LS decrease with more than 24% after 6th cycle predicted the occurrence of cardiotoxicity 6 months after CHOP completion (Sb 86%, Sp 75%).

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Abstracts > Sunday 26 August 2018
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