Table 3.
Biomarkers, echocardiographic and cardiovascular magnetic resonance findings in patients with systemic light-chainaccording to extracellular volume changes by cardiovascular magnetic resonance at 2 years post-chemotherapy
| Regressors (N = 41) | Stable (N = 52) | Progressors (N = 15) | |||||||
|---|---|---|---|---|---|---|---|---|---|
| Baseline | 2 years | P-value | Baseline | 2 years | P-value | Baseline | 2 years | P-value | |
| Clonal response | CR = 30 (73%) VGPR = 11 (27%) |
CR = 24 (46%) VGPR = 18 (35%) PR = 8 (15%) NR = 2 (4%) |
CR = 1 (7%) VGPR = 2 (13%) PR = 10 (67%) NR = 2 (13%) |
||||||
| Biomarkers | |||||||||
| NT-proBNP (ng/L) | 2370 (939–4318) | 654 (315–1246) | 0 < 0.001 | 2326 (472–4840) | 1410 (420–3727) | 0.018 | 913 (806–5526) | 2245 (1424–3876) | 0.148 |
| NT-proBNP response | Response = 28 (68%) No response = 6 (15%) 7 not classified (17%) |
Response = 16 (30%) No response = 18 (35%) 18 not classified (35%) |
Response = 2 (13%) No response = 10 (67%) 3 not classified (20%) |
||||||
| 6MWT (m) | 448 ± 118 | 479 ± 121 | 0.126 | 406 ± 97 | 420 ± 109 | 0.894 | 376 ± 180 | 415 ± 152 | 0.827 |
| Echocardiographic parameters | |||||||||
| IVS (cm) | 1.4 ± 0.3 | 1.4 ± 0.2 | 0.101 | 1.4 ± 0.3 | 1.4 ± 0.3 | 0.891 | 1.4 ± 0.3 | 1.5 ± 0.2 | 0.020 |
| LVEDD (cm) | 41.1 ± 6.5 | 42.4 ± 5.0 | 0.243 | 41.9 ± 5.5 | 42.5 ± 5.6 | 0.327 | 41.8 ± 5.3 | 40.9 ± 5.9 | 0.485 |
| LAA (cm2) | 20.6 ± 6.0 | 20.0 ± 5.3 | 0.091 | 21.0 ± 5.2 | 21.1 ± 5.3 | 0.457 | 21.8 ± 3.6 | 22.1 ± 5.0 | 0.712 |
| E/E′ | 15 ± 6 | 13 ± 5 | 0.059 | 16 ± 7 | 15 ± 6 | 0.643 | 16 ± 7 | 16 ± 5 | 0.763 |
| 2D LS | −14 ± 6 | −15 ± 4 | 0.035 | −15 ± 5 | −13 ± 9 | 0.109 | −14 ± 4 | −10 ± 8 | 0.076 |
| CMR parameters | |||||||||
| LVEDVi (mL/m2) | 65 (SD 16) | 69 (SD 14) | 0.011 | 68 (SD 16) | 72 (SD 17) | 0.028 | 64 (SD 12) | 73 (SD 28) | 0.106 |
| LVESVi (mL/m2) | 23 (SD 10) | 25 (SD 10) | 0.035 | 24 (SD 10) | 26 (SD 13) | 0.200 | 22 (SD 10) | 27 (SD 16) | 0.051 |
| LV mass index (g/m2) | 92 (SD 35) | 86 (SD 33) | 0.022 | 103 (SD 38) | 102 (SD 38) | 0.575 | 101 (30) | 116 (SD 35) | 0.303 |
| LVSVi (mL/m2) | 43 (SD 10) | 45 (SD 8) | 0.114 | 44 (SD 9) | 47 (SD 9) | 0.017 | 42 (SD 8) | 46 (SD 16) | 0.227 |
| LVEF (%) | 66 ± 9 | 67 ± 10 | 0.674 | 65 ± 8 | 65 ± 11 | 0.814 | 67 ± 10 | 63 ± 12 | 0.029 |
| LAA (cm2) | 26 ± 7 | 25 ± 6 | 0.002 | 27 ± 7 | 25 ± 5 | 0.006 | 27 ± 6 | 27 ± 5 | 0.616 |
| RA area (cm2) | 22 ± 6 | 21 ± 5 | 0.494 | 22 ± 5 | 22 ± 5 | 0.483 | 25 ± 8 | 26 ± 7 | 0.238 |
| MAPSE (mm) | 8 ± 2 | 9 ± 2 | 0.007 | 9 ± 4 | 8 ± 2 | 0.280 | 9 ± 2 | 7 ± 2 | 0.007 |
| TAPSE (mm) | 16 ± 5 | 18 ± 5 | 0.015 | 17 ± 5 | 16 ± 6 | 0.050 | 16 ± 5 | 12 ± 4 | 0.001 |
| Native T1 (ms) | 1147 ± 69 | 1100 ± 53 | 0 < 0.001 | 1139 ± 57 | 1119 ± 72 | 0.025 | 1132 ± 41 | 1155 ± 44 | 0.030 |
| T2 (ms) | 53 ± 3 | 52 ± 3 | 0.038 | 53 ± 3 | 53 ± 3 | 0.235 | 52 ± 2 | 52 ± 3 | 0.840 |
| Visual LGE improvement | 22 (54%) Transmural to subendocardial = 4 Improved subendocardial = 10 Subendocardial to no LGE = 8 |
||||||||
6MWT, 6-minute walk test; AL, systemic light-chain; CMR, cardiovascular magnetic resonance; CR, complete (haematological) response; LS, longitudinal strain; LAA, left atrial area; LGE, late gadolinium enhancement; LVEDD, left ventricular end-diastolic diameter; LVEDVi left ventricular end-diastolic volume indexed by body surface area; LVESVi, left ventricular end-systolic volume indexed by body surface area; LVSVi, left ventricular stroke volume indexed by body surface area; LVEF, left ventricular ejection fraction; MAPSE, mitral annular plane systolic excursion; NR, no (haematological) response; NT-proBNP, N-terminal pro-B-type natriuretic peptide; PR, partial (haematological) response, RA, right atrium; TAPSE, tricuspid annular plane systolic excursion; VGPR, very good partial (haematological) response.
All continuous variables are presented as mean and standard deviation with NT-proBNP presented as median and interquartile range although its natural logarithm was used for the paired comparisons.
In bold P < 0.01.