From the Guidelines
Echocardiography (echo) is used for B cell lymphoma to monitor cardiotoxicity caused by certain chemotherapies, such as anthracyclines (e.g., doxorubicin) and monoclonal antibodies (e.g., trastuzumab), which can lead to left ventricular dysfunction and heart failure 1.
Chemotherapies that Cause Cardiotoxicity
- Anthracyclines: doxorubicin, epirubicin, and mitoxantrone
- Monoclonal antibodies: trastuzumab
Echocardiography Surveillance
- Baseline echocardiographic assessment of LV function is recommended before initiation of potentially cardiotoxic cancer treatment in all patients 1
- Surveillance should be considered with echocardiography every 4 cycles of anti-HER2 treatment or after 200 mg/m2 of doxorubicin (or equivalent) for treatment with anthracyclines 1
- More frequent surveillance may be considered for patients with abnormal baseline echocardiography or those with higher baseline clinical risk 1
Importance of Early Detection
Early detection of cardiotoxicity is crucial to prevent long-term cardiac damage and improve patient outcomes 1.
Role of Biomarkers
Biomarkers such as troponin and natriuretic peptides may be useful in detecting cardiotoxicity, but their role is not yet well defined 1.
Management of Cardiotoxicity
Aggressive medical treatment with ACE inhibitors and β-blockers is recommended for patients who show LV dysfunction after anthracycline therapy, even if asymptomatic 1.
From the Research
Echocardiography in B Cell Lymphoma
- Echocardiography is used to monitor cardiac toxicity in patients with B cell lymphoma, particularly those treated with anthracycline chemotherapy 2, 3, 4, 5.
- The technique helps detect early signs of cardiotoxicity, allowing for timely intervention and prevention of long-term cardiac damage.
Chemotherapies Causing Cardiotoxicity
- Anthracycline chemotherapy is a common cause of cardiotoxicity in patients with B cell lymphoma 2, 3, 4, 5.
- Doxorubicin, a type of anthracycline, has been shown to induce cardiomyopathy and heart failure in patients with diffuse large B-cell lymphoma 3.
- R-CHOP chemotherapy, which includes anthracycline, has also been associated with declines in cardiac function in patients with lymphoma 5.
Detection of Cardiotoxicity
- Echocardiographic parameters such as Tei index, mitral annular peak systolic velocity, and left ventricular ejection fraction can be used to detect cardiotoxicity 2.
- Serum high-sensitivity cardiac troponin T (hs-cTnT) levels can also be used as a biomarker for cardiotoxicity 2, 5.
- Three-dimensional speckle tracking echocardiography (3D-STE) and three-dimensional speckle tracking imaging (3D-STI) can provide detailed information on left ventricular segmental systolic function and detect early signs of cardiotoxicity 4, 5.