Differential cardiac impacts of hematological malignancies and solid tumors: a histopathological and biomarker study

被引:1
作者
Udin, Michael H. [1 ,4 ,5 ,7 ]
Sunder, Sunitha Shyam [1 ]
Nepali, Sarmila [1 ]
Kattel, Sharma [2 ]
Abdelradi, Amr [3 ]
Doyle, Scott T. [4 ]
Ionita, Ciprian N. [4 ,5 ]
Liu, Qian [6 ]
Sharma, Umesh C. [7 ]
Pokharel, Saraswati [1 ]
机构
[1] Roswell Park Comprehens Canc Ctr, Dept Pathol & Lab Med, Buffalo, NY 14203 USA
[2] Univ Minnesota, Dept Med, Div Cardiovasc Med, Minneapolis, MN USA
[3] Univ Buffalo, Sch Med & Biomed Sci, Dept Med, Div Cardiol, Buffalo, NY USA
[4] Univ Buffalo, Dept Biomed Engn, Buffalo, NY USA
[5] Canon Stroke & Vasc Res Ctr, Buffalo, NY USA
[6] Roswell Park Comprehens Canc Ctr, Dept Biostat & Bioinformat, Buffalo, NY USA
[7] Univ Buffalo, Sch Med & Biomed Sci, Dept Med, Buffalo, NY USA
关键词
Cardiotoxicity; Cancer; Cancer therapy; Hematological malignancy; Solid tumor; Heart failure; Fibrosis; Collagen; Second harmonic generation; Acute myeloid leukemia; CARDIOVASCULAR-DISEASE; CANCER; LEUKEMIA; RISK; PREVALENCE; DIAGNOSIS; SURVIVORS;
D O I
10.1186/s40959-024-00285-3
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background Cancer patients are known to be associated with increased risk of cardiovascular disease. However, no studies have examined the differential impact of hematologic malignancies (HMs) and solid tumors (STs) on cardiac morphology at the tissue level. Objective We aimed to examine histopathological features alongside cardiovascular biomarkers in patients with HMs and STs who underwent post-mortem evaluation. Methods We analyzed cardiac changes in 198 patients with HMs and 164 patients with solid tumors STs. We compared demographics, echocardiogram data, exposure to various antineoplastic agents, and post-mortem findings. Additionally, cardiac histological validation was conducted on post-mortem cardiac specimens to examine cardiac tissue morphology, focusing on cardiomyocyte nuclear density, collagen content, and collagen fiber orientation. Results HM patients displayed significantly disordered collagen fiber alignment (0.71 vs 0.83, P = 0.027), and reduced cardiomyocyte nuclear density (56 vs 72, P = 0.002) compared to ST patients. Similarly, hemoglobin level was decreased (6.71 vs 8.06, P < 0.001) in HM patients compared to ST patients. HM patients also showed elevated B-type natriuretic peptide levels (2,275 vs 867, P < 0.001), without significant differences in creatine-kinase MB and cardiac troponin levels. Multivariate analysis identified increased right ventricular thickness, low diastolic blood pressure, and high cardiac troponin levels as risk factors for cardiac death in HM patients. Conclusions This study demonstrates that HM patients have fewer cardiomyocyte nuclei and poorly aligned collagen, with serum biomarker evidence of increased cardiac dysfunction. This supports the necessity for specialized cardiac care for these patients.
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页数:17
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