Risk factors affecting cardiac left-ventricular hypertrophy and systolic and diastolic function in the chronic phase of allogeneic hematopoietic cell transplantation.
Risk factors affecting cardiac left-ventricular hypertrophy and systolic and diastolic function in the chronic phase of allogeneic hematopoietic cell transplantation.
复制标题
影响异基因造血细胞移植慢性期心脏左心室肥厚及收缩舒张功能的危险因素。
DOI：
10.1038/bmt.2012.179
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发表时间：
2013
期刊：
影响因子：
--
通讯作者：
Hino M.
中科院分区：
文献类型：
--
作者：
Nishimoto M;Nakamae H;Koh H;Nakane T;Nakamae M;Hirose A;Hagihara K;Nakao Y;Terada Y;Ohsawa M;Hino M.
慢性心功能损害可能是一个重要的健康风险，损害生活质量，甚至可能危及异基因造血细胞移植(HCT)长期存活者的生命。然而，HCT慢性期心功能不全的危险因素和/或潜在机制仍不完全清楚。我们对慢性肥厚性心肌病患者心功能和左心室肥厚的影响因素进行了回顾性研究。63例接受HCT后存活1年的受者接受了超声心动图检查。基于简单线性回归模型，大剂量脑挫伤预适应与心脏移植后左室射血分数和早期峰值流速/心房峰值流速比值的降低显著相关(相关系数分别为−5.550和−0.268，P=0.02)。随着多元线性回归模型的使用，这些关联仍然显著。多因素Logistic回归分析显示，HCT前血清铁蛋白(S铁蛋白)水平是左心室肥厚的重要危险因素(P=0.03)。综上所述，我们的研究表明，清髓方案，特别是大剂量颅脑损伤的方案，会损害心功能，并且高水平的S-铁蛋白可能与慢性肥厚的发生有关。
Chronic impairment of cardiac function can be an important health risk and impair the quality of life, and may even be life-threatening for long-term survivors of allogeneic hematopoietic cell transplantation (HCT). However, risk factors for and/or the underlying mechanism of cardiac dysfunction in the chronic phase of HCT are still not fully understood. We retrospectively investigated factors affecting cardiac function and left-ventricular hypertrophy (LVH) in the chronic phase of HCT. Sixty-three recipients who survived for> 1 year after receiving HCT were evaluated using echocardiography. Based on simple linear regression models, high-dose TBI-based conditioning was significantly associated with a decrease in left-ventricular ejection fraction and the early peak flow velocity/atrial peak flow velocity ratio, following HCT (coefficient=− 5.550, P= 0.02 and coefficient=− 0.268, P= 0.02, respectively). These associations remained significant with the use of multiple linear regression models. Additionally, the serum ferritin (s-ferritin) level before HCT was found to be a significant risk factor for LVH on multivariable logistic analysis (P= 0.03). In conclusion, our study demonstrated that a myeloablative regimen, especially one that involved high-dose TBI, impaired cardiac function, and that a high s-ferritin level might be associated with the development of LVH in the chronic phase of HCT.