Multiple myeloma (MM) affects a population with a high prevalence of cardiovascular (CV) disease. These patients benefit from an accurate CV risk evaluation in order to choose the safest drug regimen. Haemodynamic forces (HDFs) analysis allows for the earlier detection of myocardial damage compared with standard markers; the role played by MM in HDFs alteration, with or without the influence of hypertension, is yet to be studied. Therefore, we aimed to identify differences in HDFs analysis in patients with MM, hypertension or both versus normotensive non-oncologic subjects. A total of 173 patients (MM hypertensive patients, MMHT; MM normotensive patients, MMNT; non-oncologic hypertensive patients, CoHT; and non-oncologic normotensive patients, CoNT) underwent transthoracic echocardiography for HDFs analysis and pulse wave velocity (PWV) assessment. Hypertensive patients (MMHT, CoHT) showed decreased ejection fraction (EF), global longitudinal strain (GLS) and HDFs values compared with CoNT, whereas ventricular mass (LVMi) and PWV increased. MMNT displayed a significant reduction in systolic HDFs (p< 0.006) and systolic ejection HDFs (p< 0.008) compared with CoNT, without significant change in EF, GLS, LVMi or PWV. In conclusion, MM leads to ventricular remodelling regardless of hypertension; HDFs application for MM patients could help detect early myocardial damage, especially in patients receiving cardiotoxic drugs.
多发性骨髓瘤（MM）患者群体中心血管（CV）疾病患病率较高。为选择最安全的药物治疗方案，这些患者需进行准确的心血管风险评估。与标准标志物相比，血流动力学力（HDFs）分析能更早检测心肌损伤，但MM在高血压影响或非高血压状态下对HDFs改变的作用机制尚未明确。本研究旨在比较MM患者、高血压患者或两者兼有者与血压正常的非肿瘤受试者之间HDFs分析的差异。共纳入173例患者（MM合并高血压组MMHT、MM血压正常组MMNT、非肿瘤高血压组CoHT及非肿瘤血压正常组CoNT），接受经胸超声心动图检查进行HDFs分析和脉搏波速度（PWV）评估。与CoNT组相比，高血压患者（MMHT、CoHT组）显示射血分数（EF）、整体纵向应变（GLS）及HDFs值降低，而心室质量指数（LVMi）和PWV升高。MMNT组与CoNT组相比，收缩期HDFs（p<0.006）和收缩期射血HDFs（p<0.008）显著降低，但EF、GLS、LVMi及PWV无显著变化。结论：无论是否合并高血压，MM均可导致心室重构；对MM患者应用HDFs分析有助于早期发现心肌损伤，尤其适用于接受心脏毒性药物治疗的患者。
肿瘤(癌症)患者之家