Cardiopulmonary Functional Profiles in Cancer Therapy-Related Cardiac Dysfunction Among Patients with Non-Hodgkin Lymphoma

TL;DR

This study shows that cardiopulmonary exercise testing can help identify early signs of heart dysfunction in NHL patients undergoing cancer treatment.

Contribution

The study demonstrates the potential of CPET as an early predictor of cancer therapy-related cardiac dysfunction in NHL patients.

Findings

14.2% of NHL patients developed asymptomatic CTRCD within six months of treatment.

CTRCD patients had lower work rates, VO2 at the anaerobic threshold, and O2 consumption efficiency.

Baseline peak oxygen consumption correlated with left ventricle ejection fraction at six months.

Abstract

Background: Non-Hodgkin lymphoma (NHL) is associated with significant cardiovascular risks due to treatment-related toxicities, including cancer therapy-related cardiac dysfunction (CTRCD). While multimodality imaging, particularly echocardiography, is pivotal in monitoring cardiac function, the prognostic role of cardiopulmonary exercise testing (CPET) in predicting CTRCD remains underexplored. Methods: The prospective study enrolled 127 NHL patients, 72 men (56.7%) and 55 women (43.3%), with a median age of 62 years (range 34–83 years). The patients were assessed before initiating antitumor treatment and at six months follow-up using echocardiography and cardiopulmonary exercise testing. Results: Asymptomatic CTRCD occurred in 14.2% of NHL patients at six months of treatment. Patients with CTRCD exhibited significantly lower median work rates, volume of oxygen (VO2) at the anaerobic threshold, and O2 consumption efficiency, reflecting compromised metabolic and functional performance. Baseline peak oxygen consumption (VO2 peak) positively correlated with left ventricle ejection fraction (LVEF) at six months, while VO₂ peak < 14 mL/kg/min was negatively associated with LVEF. Conclusions: Asymptomatic CTRCD was identified in 14.2% of NHL patients at six months, with lower work rates, VO2 at the anaerobic threshold, and O2 consumption efficiency, indicating impaired performance. Baseline peak oxygen consumption correlated positively with LVEF, highlighting CPET’s potential for early CTRCD risk assessment.

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