Title:Assessment of Left Ventricular Diastolic Function in Patients with Diffuse Large
B-cell Lymphoma after Anthracycline Chemotherapy by using Vector Flow
Mapping
Volume: 20
Author(s): Kun Yang, Jia Hu, Xinchun Yuan*, Yu Xiahou and Ping Ren
Affiliation:
- Department of Ultrasound Medicine, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang 330006, China
Keywords:
Energy loss, Intraventricular pressure difference, Diffuse large B-cell lymphoma, Anthracycline, Vector flow mapping, Chemotherapy.
Abstract:
Background:
Patients with diffuse large B-cell lymphoma (DLBCL) often experience a poor prognosis due to cardiac damage induced by anthracycline
chemotherapy, with left ventricular diastolic dysfunction manifesting early. Vector Flow Mapping (VFM) is a novel technology, and its
effectiveness in detecting left ventricular diastolic dysfunction following anthracycline chemotherapy remains unverified.
Object:
This study evaluates left ventricular diastolic function in DLBCL patients after anthracycline chemotherapy using vector flow mapping (VFM).
Materials and Methods:
We prospectively enrolled 54 DLBCL patients who had undergone anthracycline chemotherapy (receiving a minimum of 4 cycles) as the case
group and 54 age- and sex-matched individuals as controls. VFM assessments were conducted in the case group pre-chemotherapy (T0), post-4
chemotherapy cycles (T4), and in the control group. Measurements included basal, middle, and apical segment energy loss (ELb, ELm, ELa) and
intraventricular pressure differences (IVPDb, IVPDm, IVPDa) across four diastolic phases: isovolumic relaxation (D1), rapid filling (D2), slow
filling (D3), and atrial contraction (D4).
Results:
When comparing parameters between the control and case groups at T0, no significant differences were observed in general data, conventional
ultrasound parameters, and VFM parameters (all P > 0.05). From T0 to T4, ELa significantly increased throughout the diastole cycle (all P < 0.05);
ELm increased only during D4 (all P < 0.05); and ELb increased during D1, D2, and D4 (all P < 0.05). All IVPD measurements (IVPDa, IVPDm,
IVPDb) increased during D1 and D4 (all P < 0.05) but decreased during D2 and D3 (all P < 0.05). Significant positive correlations were identified
between ELa-D4, IVPDa-D4, and parameters A, e’, E/e,’ and LAVI (all r > 0.5, all P < 0.001). Negative correlations were noted with E/A for ELa-
D4 IVPDa-D4 (all r < -0.5, all P < 0.001). Positive correlations were observed for IVPDa-D1, IVPDa-D2 with E, E/e’, and LAVI (0.3<r<0.5, all
P<0.001).
Conclusion:
VFM parameters demonstrate a certain correlation with conventional diastolic function parameters and show promise in assessing left ventricular
diastolic function. Furthermore, VFM parameters exhibit greater sensitivity to early diastolic function changes, suggesting that VFM could be a
novel method for evaluating differences in left ventricular diastolic function in DLBCL patients before and after chemotherapy.
