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KMID : 0857220040080020430
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Journal of the Korean Pediatric Cardiology Society
2004 Volume.8 No. 2 p.430 ~ p.436
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The Changes of Cardiac Function after Bone Marrow Transplantation
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Kwon Young-Joo
Lee Soon-Ju
Kim Hack-Ki
Oh Jin-Hee
Oh Chang-Kyu
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Abstract
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Purpose: Introduction of bone marrow transplantation(BMT) as a treatment of oncologic disease markedly improved the survival rate of patients. But, acute and chronic complications after BMT including cardiac problems affect the morbidity and mortality in the post-BMT period. This study was to assess the cardiac functional changes after BMT with echocardiography and to evaluate the variables affecting the post-BMT cardiac function.
Methods: One hundred and four patients, undergoing allogeneic(n=95) or autologous (n=9) BMT, were studied with echocardiography before and after BMT. Among these 104 patients, 20 patients had abnormal cardiac function and they underwent further echocardiographic investigation for systolic and diastolic function. Patients were divided into two groups(one group with abnormal cardiac function and the other group with normal cardiac function after BMT). We compared the differences in clinical characteristics, echocardiographic data, pretreatment agents before BMT including cyclophosphamide and total body irradiation(TBI) between the two groups.
Results: Twenty patients among the 104 patients had abnormal cardiac function in echocardiography after the BMT. Two groups showed no significant differences in age, sex and pretreatment agents before BMT with cyclophosphamide or TBI. In the patients with abnormal cardiac function after BMT, systolic and diastolic echocardiographic data of pre-BMT were compared with those of post-BMT. They showed significant prolongation of isovolumic relaxation time(IVRT) and increment of thickness of interventricular septum after BMT. But, there were no significant differences in ejection fraction (EF), fractional shortening(FS), left ventricular end-diastolic dimension(LVEDD), left ventricular end-systolic dimension(LVESD), deceleration time and E/A ratio.
Conclusion: Cardiac function of the patients may be deteriorated subclinically in the early phase after BMT. So, assessment of cardiac function with echocardiography in the early weeks after BMT and early intervention of treatment are recommended to reduce the morbidity and mortality of the post-BMT patients.
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KEYWORD
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Bone marrow transplantation, Cardiac function
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