Study of the initial vasculotoxic risk in patients with lymphoproliferative diseases before the start of polychemotherapy

Research objective. To evaluate the levels of CRP, cardio-specific markers, lipids, structural-functional (SF) state of vessels, and their interrelations in patients with lymphoproliterative diseases (LPD) before polychemotherapy (PCT).

Materials and methods. The study included patients with newly diagnosed LPD (n = 30), including 16 men (53.3%) and 14 women (46.7%). All patients were divided into two groups: group 1 (n = 15) — patients with low/intermediate cardiovascular toxicity (CVT) risk; group 2 (n = 15) — patients with high/very high CVT risk. CVT risk stratification was performed with the use of specialized scales according to the current European clinical guidelines for cardio-oncology 2022. All patients included in the study underwent standard laboratory and instrumental examinations. Specific laboratory research involved assessing the levels of C-reactive protein (CRP), troponin I (TnI), N-terminal pro-brain natriuretic peptide (NT-proBNP), and lipid profile. The SF state of vessels was evaluated non-invasively using photoplethysmography (PPG) (Angioscan-01 device, Russia) and computerized videocapillaroscopy (CVC) of the periungual area (Capillaroscan-01 device, Russia).

Results. According to the results of PPG and CVC, the occlusion index (OI) in group 2 was significantly lower and amounted to 1.2 [1; 1.3] compared to 1.7 [1.45; 2.1] in group 1 (p < 0.001); capillary density after reactive hyperemia (CDRH) was also significantly lower in group 2 compared to group 1 — 43 [35.5; 45] and 54 [43; 58] cap/mm², respectively (p = 0.033). According to the obtained results, there were no statistically significant diff erences in the levels of CRP, TnI, and NT-proBNP between patients in both groups; the indicators were within the reference values. A moderate inverse statistically signifi cant correlation was found between the level of CRP and the percentage of perfused capillaries (PPC) (rs = –0.545; p =  0.02) and the percentage of capillary recovery (PCR) (r = –0.446; p = 0.013).

Conclusion. Patients with LPD have endothelial dysfunction before PCT, primarily due to the presence of cardiovascular risk factors (age, body mass index), and concomitant cardiovascular diseases. At the same time, the SF state of vessels initially does not depend on the stage and course of LPD, lipid levels, and TnI.

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