Correlation between the level of C-reactive protein and the parameters of the functional status of the left atrium in patients with lymphoproliferative diseases against the background of chemotherapy

Aim. To assess the dynamics of functional changes in the left atrium (LA) in patients with lymphoproliferative diseases (LPD) before polychemotherapy (PCT), during treatment, after 6 courses of treatment, and the frequency of supraventricular arrhythmias (SVA) as well as the level of C-reactive protein. Material and methods. This is a prospective observational study of patients with confirmed diagnosis of lymphoma (n = 30; 57% men; median age 52 [34; 65] years old), who had no prior polychemotherapy. The comparison group included persons without lymphoma (n = 30; 49% men; median age 49 [36; 65] years old) comparable to the main group in terms of sex, age and risk factors for cardiovascular diseases. Patients with lymphoma underwent 24h-ECG monitoring and advanced transthoracic echocardiography with 2D speckle-tracking at baseline, and after 3 and 6 cycles (within 3 and 6 months) of anticancer treatment. Biomarkers of inflammation were measured. The results were compared to the data of the comparison group. Results. In lymphoma patients GLS LA, LA strain reservoir, LA strain conduit, and LA strain booster pump were found to be impaired at baseline but were comparable with these in matched controls. There was a significant decrease in GLS LA (LA strain reservoir 30% [26–41] vs 17% [15–31], p = 0.015) after 6 courses of PCT. In lymphoma patients before PCT, supraventricular tachycardia (SVT) was recorded significantly more often than in patients of the comparison group: 53% (n = 16) versus 20% (n = 6), (p = 0.02). The frequency of SVT was comparable in patients with LPD before and after 6 courses of chemotherapy: 53% (n = 16) vs 47% (n = 14) (p = 0 .7). Associations between the parameters of structural and functional changes in the LA and the incidence of SVA were not identified. A close correlation was found between the level of ESR, CRP and the parameters of the functional state of the LA. There was a significant relationship of the average strength between the ESR and the number of SVE in the analysis at all control points (r_xy = 0.44, p < 0.05). Conclusions. In lymphoma patients LA dysfunction occurs, which progressively worsens against the background of antitumor therapy, and is associated with the severity of systemic inflammation that may be a manifestation of the cardiotoxic effect of PCT, but additional studies are required.

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