The injured heart

Early cardiac effects of hematopoietic stem cell transplantation in children and young adults

S. J. Rotz, T. D. Ryan, S. Jodele, John Jefferies, A. Lane, A. Pate, R. Hirsch, J. Hlavaty, A. E. Levesque, M. D. Taylor, M. Cash, K. C. Myers, J. A. El-Bietar, S. M. Davies, C. E. Dandoy

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

We hypothesized that subclinical cardiac injury in the peri-transplant period is more frequent than currently appreciated in children and young adults. We performed echocardiographic screening on 227 consecutive patients prior to hematopoietic stem cell transplantation (HSCT), and 7, 30 and 100 days after transplant. We measured cardiac biomarkers cardiac troponin-I (cTn-I), and soluble suppressor of tumorigenicity 2 (sST2) prior to transplant, during conditioning, and days +7, +14, +28 and +49 in 26 patients. We subsequently analyzed levels of cTn-I every 48-72 h in 15 consecutive children during conditioning. Thirty-two percent (73/227) of patients had a new abnormality on echocardiogram. New left ventricular systolic dysfunction (LVSD) occurred in 6.2% of subjects and new pericardial effusion in 27.3%. Eight of 227 (3.5%) patients underwent pericardial drain placement, and 5 (2.2%) received medical therapy for clinically occult LVSD. cTn-I was elevated in 53.0% of all samples and sST2 in 38.2%. At least one sample had a detectable cTn-I in 84.6% of patients and an elevated sST2 in 76.9%. Thirteen of fifteen patients monitored frequently during condition had elevation of cTn-I. Echocardiographic and biochemical abnormalities are frequent in the peri-HSCT period. Echocardiogram does not detect all subclinical cardiac injuries that may become clinically relevant over longer periods.

Original languageEnglish (US)
Pages (from-to)1171-1179
Number of pages9
JournalBone Marrow Transplantation
Volume52
Issue number8
DOIs
StatePublished - Aug 1 2017

Fingerprint

Hematopoietic Stem Cell Transplantation
Young Adult
Troponin I
Left Ventricular Dysfunction
Transplants
Pericardial Effusion
Wounds and Injuries
Biomarkers

All Science Journal Classification (ASJC) codes

  • Hematology
  • Transplantation

Cite this

The injured heart : Early cardiac effects of hematopoietic stem cell transplantation in children and young adults. / Rotz, S. J.; Ryan, T. D.; Jodele, S.; Jefferies, John; Lane, A.; Pate, A.; Hirsch, R.; Hlavaty, J.; Levesque, A. E.; Taylor, M. D.; Cash, M.; Myers, K. C.; El-Bietar, J. A.; Davies, S. M.; Dandoy, C. E.

In: Bone Marrow Transplantation, Vol. 52, No. 8, 01.08.2017, p. 1171-1179.

Research output: Contribution to journalArticle

Rotz, SJ, Ryan, TD, Jodele, S, Jefferies, J, Lane, A, Pate, A, Hirsch, R, Hlavaty, J, Levesque, AE, Taylor, MD, Cash, M, Myers, KC, El-Bietar, JA, Davies, SM & Dandoy, CE 2017, 'The injured heart: Early cardiac effects of hematopoietic stem cell transplantation in children and young adults', Bone Marrow Transplantation, vol. 52, no. 8, pp. 1171-1179. https://doi.org/10.1038/bmt.2017.62
Rotz, S. J. ; Ryan, T. D. ; Jodele, S. ; Jefferies, John ; Lane, A. ; Pate, A. ; Hirsch, R. ; Hlavaty, J. ; Levesque, A. E. ; Taylor, M. D. ; Cash, M. ; Myers, K. C. ; El-Bietar, J. A. ; Davies, S. M. ; Dandoy, C. E. / The injured heart : Early cardiac effects of hematopoietic stem cell transplantation in children and young adults. In: Bone Marrow Transplantation. 2017 ; Vol. 52, No. 8. pp. 1171-1179.
@article{60c13d94d87449bba079fbebe7863e33,
title = "The injured heart: Early cardiac effects of hematopoietic stem cell transplantation in children and young adults",
abstract = "We hypothesized that subclinical cardiac injury in the peri-transplant period is more frequent than currently appreciated in children and young adults. We performed echocardiographic screening on 227 consecutive patients prior to hematopoietic stem cell transplantation (HSCT), and 7, 30 and 100 days after transplant. We measured cardiac biomarkers cardiac troponin-I (cTn-I), and soluble suppressor of tumorigenicity 2 (sST2) prior to transplant, during conditioning, and days +7, +14, +28 and +49 in 26 patients. We subsequently analyzed levels of cTn-I every 48-72 h in 15 consecutive children during conditioning. Thirty-two percent (73/227) of patients had a new abnormality on echocardiogram. New left ventricular systolic dysfunction (LVSD) occurred in 6.2{\%} of subjects and new pericardial effusion in 27.3{\%}. Eight of 227 (3.5{\%}) patients underwent pericardial drain placement, and 5 (2.2{\%}) received medical therapy for clinically occult LVSD. cTn-I was elevated in 53.0{\%} of all samples and sST2 in 38.2{\%}. At least one sample had a detectable cTn-I in 84.6{\%} of patients and an elevated sST2 in 76.9{\%}. Thirteen of fifteen patients monitored frequently during condition had elevation of cTn-I. Echocardiographic and biochemical abnormalities are frequent in the peri-HSCT period. Echocardiogram does not detect all subclinical cardiac injuries that may become clinically relevant over longer periods.",
author = "Rotz, {S. J.} and Ryan, {T. D.} and S. Jodele and John Jefferies and A. Lane and A. Pate and R. Hirsch and J. Hlavaty and Levesque, {A. E.} and Taylor, {M. D.} and M. Cash and Myers, {K. C.} and El-Bietar, {J. A.} and Davies, {S. M.} and Dandoy, {C. E.}",
year = "2017",
month = "8",
day = "1",
doi = "10.1038/bmt.2017.62",
language = "English (US)",
volume = "52",
pages = "1171--1179",
journal = "Bone Marrow Transplantation",
issn = "0268-3369",
publisher = "Nature Publishing Group",
number = "8",

}

TY - JOUR

T1 - The injured heart

T2 - Early cardiac effects of hematopoietic stem cell transplantation in children and young adults

AU - Rotz, S. J.

AU - Ryan, T. D.

AU - Jodele, S.

AU - Jefferies, John

AU - Lane, A.

AU - Pate, A.

AU - Hirsch, R.

AU - Hlavaty, J.

AU - Levesque, A. E.

AU - Taylor, M. D.

AU - Cash, M.

AU - Myers, K. C.

AU - El-Bietar, J. A.

AU - Davies, S. M.

AU - Dandoy, C. E.

PY - 2017/8/1

Y1 - 2017/8/1

N2 - We hypothesized that subclinical cardiac injury in the peri-transplant period is more frequent than currently appreciated in children and young adults. We performed echocardiographic screening on 227 consecutive patients prior to hematopoietic stem cell transplantation (HSCT), and 7, 30 and 100 days after transplant. We measured cardiac biomarkers cardiac troponin-I (cTn-I), and soluble suppressor of tumorigenicity 2 (sST2) prior to transplant, during conditioning, and days +7, +14, +28 and +49 in 26 patients. We subsequently analyzed levels of cTn-I every 48-72 h in 15 consecutive children during conditioning. Thirty-two percent (73/227) of patients had a new abnormality on echocardiogram. New left ventricular systolic dysfunction (LVSD) occurred in 6.2% of subjects and new pericardial effusion in 27.3%. Eight of 227 (3.5%) patients underwent pericardial drain placement, and 5 (2.2%) received medical therapy for clinically occult LVSD. cTn-I was elevated in 53.0% of all samples and sST2 in 38.2%. At least one sample had a detectable cTn-I in 84.6% of patients and an elevated sST2 in 76.9%. Thirteen of fifteen patients monitored frequently during condition had elevation of cTn-I. Echocardiographic and biochemical abnormalities are frequent in the peri-HSCT period. Echocardiogram does not detect all subclinical cardiac injuries that may become clinically relevant over longer periods.

AB - We hypothesized that subclinical cardiac injury in the peri-transplant period is more frequent than currently appreciated in children and young adults. We performed echocardiographic screening on 227 consecutive patients prior to hematopoietic stem cell transplantation (HSCT), and 7, 30 and 100 days after transplant. We measured cardiac biomarkers cardiac troponin-I (cTn-I), and soluble suppressor of tumorigenicity 2 (sST2) prior to transplant, during conditioning, and days +7, +14, +28 and +49 in 26 patients. We subsequently analyzed levels of cTn-I every 48-72 h in 15 consecutive children during conditioning. Thirty-two percent (73/227) of patients had a new abnormality on echocardiogram. New left ventricular systolic dysfunction (LVSD) occurred in 6.2% of subjects and new pericardial effusion in 27.3%. Eight of 227 (3.5%) patients underwent pericardial drain placement, and 5 (2.2%) received medical therapy for clinically occult LVSD. cTn-I was elevated in 53.0% of all samples and sST2 in 38.2%. At least one sample had a detectable cTn-I in 84.6% of patients and an elevated sST2 in 76.9%. Thirteen of fifteen patients monitored frequently during condition had elevation of cTn-I. Echocardiographic and biochemical abnormalities are frequent in the peri-HSCT period. Echocardiogram does not detect all subclinical cardiac injuries that may become clinically relevant over longer periods.

UR - http://www.scopus.com/inward/record.url?scp=85017283929&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85017283929&partnerID=8YFLogxK

U2 - 10.1038/bmt.2017.62

DO - 10.1038/bmt.2017.62

M3 - Article

VL - 52

SP - 1171

EP - 1179

JO - Bone Marrow Transplantation

JF - Bone Marrow Transplantation

SN - 0268-3369

IS - 8

ER -