Left Atrial Function in Patients With Diffuse Large B-Cell Lymphoma Treated With R-CHOP Chemotherapy Regimen: A Speckle Tracking Echocardiographic Study.

OBJECTIVE

This study aimed to determine whether left atrial (LA) strain can identify early alterations in LA function in diffuse large B-cell lymphoma (DLBCL) patients treated with R-CHOP chemotherapy regimen and whether these alterations can prospectively predict the subsequent development of cancer therapy-related cardiac dysfunction (CTRCD).

METHODS

DLBCL patients scheduled to receive the R-CHOP regimen were prospectively recruited for this study. Echocardiography was performed at T0 (pre-chemotherapy), T1 (after the third cycle), T2 (end of 6-8 cycles), and T3 (1-year post-T2). Left ventricular global longitudinal strain (LV GLS), LA reservoir strain (LASr), LA conduit strain (LAScd), LA contraction strain (LASct), and LA stiffness index (LASI) were calculated using speckle tracking echocardiography (STE). Patients were divided into CTRCD and non-CTRCD groups based on a > 15% reduction in LV GLS.

RESULTS

Seventeen patients (23.6%) developed to CTRCD after chemotherapy. Patients who developed CTRCD were relatively older (67 [57-71] vs. 60 [49-68], p < 0.05). A significant deterioration in LASr, LAScd, and LASI at T1 persisted throughout the follow-up period. Relative changes in LASr (≥ 23.4%) and LASI (≥ 20.0%) were robust predictors of subsequent CTRCD development. The LASr > 35% criterion in the validation cohort demonstrated substantial agreement with the 2016 ASE guidelines.

CONCLUSION

LASr and LASI effectively identify early alterations in LA function in DLBCL patients. Relative changes in LASr and LASI are robust predictors of subsequent CTRCD development.