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Evaluation of Cardiovascular Toxicity Associated with Treatments Containing Proteasome Inhibitors in Multiple Myeloma Therapy
- Source :
- High Blood Pressure & Cardiovascular Prevention. 25:209-218
- Publication Year :
- 2018
- Publisher :
- Springer Science and Business Media LLC, 2018.
-
Abstract
- Recently new treatment options have substantially increased survival for patients with relapsed and/or refractory multiple myeloma (RRMM). Among these, proteasome inhibitors (PI), such as bortezomib and carfilzomib, offer high response rate and prolonged survival. These agents are generally well tolerated but demonstrated a significant cardiovascular toxicity, mostly for regimen containing carfilzomib. To assess the cardiovascular damage in patients treated with PI for RRMM. 28 consecutive subjects treated with PI for RRMM were evaluated and compared with a population of 22 control (Con) subjects, matched for age, sex and mean 24 h blood pressure (24hMBP). All individuals underwent trans-thoracic echocardiography, ambulatory blood pressure monitoring and pulse wave velocity (PVW) study. PI patients did not have significant differences in blood pressure load and PWV compared to controls. Among echocardiographic parameters, the global longitudinal strain (GLS) was significantly decreased in PI subjects (p = 0.02). The GLS was significantly lower also considering only patients treated with carfilzomib. Moreover, among carfilzomib patients, we found increase values of left ventricle mass indexed by BSA (LVMi; p = 0.047). After correction for age, sex, BSA, 24hMBP and morphological and functional parameters of LV, treatment with PI and carfilzomib were significantly associated with GLS (p = 0.01; p = 0.036, respectively). PI treatment is associated with subclinical LV dysfunction in patients with RRMM compared to controls, as demonstrated by lower GLS values. These results are confirmed also considering patients treated with carfilzomib. Moreover, in this subgroup of patients, the LVMi is also increased, suggesting higher cardiotoxicity with this treatment.
- Subjects :
- Global longitudinal strain
Male
Cardiovascular toxicity
Carfilzomib
Multiple myeloma
Proteasome inhibitors
Aged
Antineoplastic Agents
Asymptomatic Diseases
Bortezomib
Cardiotoxicity
Case-Control Studies
Echocardiography, Doppler
Female
Humans
Middle Aged
Multiple Myeloma
Oligopeptides
Proteasome Endopeptidase Complex
Proteasome Inhibitors
Risk Factors
Treatment Outcome
Ventricular Dysfunction, Left
Ventricular Function, Left
Left
030204 cardiovascular system & hematology
chemistry.chemical_compound
0302 clinical medicine
Ventricular Dysfunction
Ventricular Function
Pulse wave velocity
education.field_of_study
Doppler
Echocardiography
030220 oncology & carcinogenesis
Cardiology and Cardiovascular Medicine
medicine.drug
medicine.medical_specialty
Ambulatory blood pressure
Population
Urology
03 medical and health sciences
Internal Medicine
medicine
education
business.industry
medicine.disease
Blood pressure
chemistry
business
Subjects
Details
- ISSN :
- 11791985 and 11209879
- Volume :
- 25
- Database :
- OpenAIRE
- Journal :
- High Blood Pressure & Cardiovascular Prevention
- Accession number :
- edsair.doi.dedup.....23080e82866ed69503f250eb2c483501