Summed rest score in gated myocardial perfusion imaging is a good predicator for treatment-related cardiotoxicity after anthracycline chemotherapy in diffuse large B-cell lymphoma patients

Background: Anthracycline chemotherapy is commonly used in the treatment of diffuse large B-cell lymphoma (DLBCL) patients. Treatment-related cardiotoxicity (TRC) may be observed during treatment and may induce severe cardiac failure or cardiac arrhythmia as the main cause of death, even several years after chemotherapy implementation. Herein, we performed a study to investigate the prognostic value of gated myocardial perfusion imaging (G-MPI) summed rest score (SRS) for the early detection of TRC caused by anthracycline chemotherapy in DLBCL patients.Methods: A total of 36 DLBCL patients were enrolled, and a series of parameters from the same individual patient were compared between baseline and after the end of the 6th R-CHOP chemotherapeutic regimen. According to whether TRC occurred during the observation period, the patients were divided into two groups, and parameters related to cardiac function were compared.Results: SRS in G-MPI and QTc interval in electrocardiogram were significantly different before and after chemotherapy (P = 0.012 and P = 0.015, respectively).By comparing parameters related to cardiac function between the TRC group (n = 22) and the no-TRC group (n = 14), only SRS was significantly different (P = 0.012). Multivariate logistic regression analysis showed that the SRS level was the only independent predicator for TRC (P = 0.018, HR = 6.053, 95% CI: 1.364-26.869). Receiver operating characteristic curve analysis identified an optimal SRS cutoff of >1for predicting TRC after anthracycline chemotherapy (P＜ 0.001).Conclusion: The G-MPI SRS level was an early indicator for TRC surveillance in DLBCL patients after anthracycline chemotherapy, thus contributing to early treatment and a subsequent decrease in mortality caused by such cardiovascular complications.

Neutrophil: lymphocyte ratio is positively associated with subclinical diabetic cardiomyopathy

Background: Subclinical diabetic cardiomyopathy (DCM) occurs frequently in asymptomatic subjects with Type 2 diabetes mellitus (T2DM). It is widely known that inflammation is related to T2DM, but few studies have shown a direct relationship between the immune system and DCM using reliable biomarkers.Methods: 507 subjects with T2DM were recruited from April 2018 to October 2019. Myocardial function was evaluated with standard echocardiography, and ischemia was excluded by gated-myocardial perfusion imaging (including rest and stress). Adjusted logistic regression models were used to evaluate relationship between NLR and subclinical DCM (covariates: age, sex, BMI, duration of diabetes, and hyperlipidemia). Furthermore, to determine time-dependent changes of NLR, blood samples were collected from T2DM mice in different age groups.Results: The incidence of DCM was 8.88%. The adjusted odds ratio (95% CI) of the highest NLR quartile was 14.32 (2.92-70.31) compared to the lowest quartile of NLR after multiple adjusted. Neutrophil and lymphocyte counts did not significantly relate to the incidence of DCM in T2DM patients. Moreover, NLR was upregulated in blood samples of T2DM mouse model and the upregulation preceded cardiac dysfunction.Conclusions: The present study demonstrated that NLR was related to the incidence and progression of subclinical DCM, suggesting that NLR may be an efficient and accurate prognostic biomarker for DCM.Trial registration: Chinese Clinical Trial Registry (ChiCTR1900027080). Registered 30 October 2019. Retrospectively registered: www.medresman.org*These authors contributed equally to this work.