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The serial changes in myocardial functions after paediatric haematopoietic stem cell transplantation

Published online by Cambridge University Press:  14 September 2022

Zehra Diyar Tamburacı Uslu Open the ORCID record for Zehra Diyar Tamburacı Uslu [Opens in a new window] ,
Filiz Ekici ,
Koray Yalçın ,
Alphan Küpesiz ,
Elif Güler  and
Levent Dönmez
Zehra Diyar Tamburacı Uslu*
Affiliation:
Pediatric Cardiology, Antalya Training and Research Hospital, Antalya, Turkey
Filiz Ekici
Affiliation:
Pediatric Cardiology, Akdeniz University Hospital, Antalya, Turkey
Koray Yalçın
Affiliation:
Pediatric Hematology, Akdeniz University Hospital, Antalya, Turkey
Alphan Küpesiz
Affiliation:
Pediatric Hematology, Akdeniz University Hospital, Antalya, Turkey
Elif Güler
Affiliation:
Pediatric Hematology, Akdeniz University Hospital, Antalya, Turkey
Levent Dönmez
Affiliation:
Public Health, Akdeniz University Medicine Faculty, Antalya, Turkey
*
Author for correspondence: Dr Zehra Diyar Tamburacı Uslu, Pediatric Cardiology, Antalya Training and Research Hospital, Antalya, Turkey. E-mail: tamburacizehra@gmail.com
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Abstract

The aim of this study is to evaluate the changes in myocardial functions in children who underwent haematopoietic stem cell transplantation along with associated chemotherapy. Additionally, we evaluated the effect of baseline echocardiographic parameters on mortality. We evaluated 39 patients (mean age 7.4 years) who underwent haematopoietic stem cell transplantation owing to non-malignant disease. The control group included 39 healthy children who had normal cardiac findings. The myocardial functions were evaluated in all subjects by conventional echocardiography and tissue Doppler echocardiography before haematopoietic stem cell transplantation and in the 1st, 3rd, 6th, and 12th month after haematopoietic stem cell transplantation. All patients had normal left ventricular ejection fraction before haematopoietic stem cell transplantation, except one case. Before haematopoietic stem cell transplantation, the patient group had significantly greater mean pulmonary artery pressure and lower tricuspid valve annular plane excursion rate. Baseline E’ velocities for mitral lateral annuli, septum, and tricuspid lateral annuli were lower in the patient group than the control group. The E’ velocities for the left ventricle decreased in the patient group after haematopoietic stem cell transplantation, and then returned to baseline levels at the 6 months. E’ and S’ velocities for tricuspid lateral annuli also decreased after haematopoietic stem cell transplantation and were still depressed in the first year after haematopoietic stem cell transplantation. Baseline E’ velocity for septum was significantly lower in patients who died after haematopoietic stem cell transplantation than patients who survived (p = 0.009). Subclinical impairment in both ventricular functions was observed after haematopoietic stem cell transplantation and the right ventricular functions were affected for longer periods than left ventricle after haematopoietic stem cell transplantation. The myocardial functions should be monitored after the first year of haematopoietic stem cell transplantation.

Keywords

Haematopoietic stem cell transplantationmyocardial functioncardiac markerchildren
Type
Original Article
Information
Cardiology in the Young , Volume 33 , Issue 9 , September 2023 , pp. 1606 - 1613
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Copyright
© The Author(s), 2022. Published by Cambridge University Press

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