Evaluation of right ventricle functions using advanced ecocardiographic methods before and after the procedure in bone marrow transplant patients

Introduction and Objective: In this study, we aimed to measure pulmonary artery stiffness (PAS) before and after BMT and to evaluate the right ventricle with advanced echocardiographic methods to detect subclinical/clinical right ventricular dysfunction and pulmonary vascular changes that may develop after BMT. Method: 45 allogeneic or autologous bone marrow transplantation (BMT) patients between the ages of 18-65 and 45 healthy control groups were included in the study, and the 1st month data of the patients who underwent BMT were also evaluated. Socio-demographic characteristics, laboratory data and echocardiographic evaluations of both groups were analyzed. In conventional echocardiography, right and left ventricular systolic and diastolic diameters and right myocardial performance index (MPI), right ventricular diastolic function, estimated systolic pulmonary artery pressure and pulmonary artery stiffness (PAS) measurements were evaluated. With 4- dimensional echocardiography, right ventricular diastolic and systolic volumes, right ventricular ejection fraction, and right ventricular fractional area change were evaluated. In addition, right ventricular strain was evaluated by Strain echocardiography. Results: In our study, right ventricular global (SaV GS) (-19.242±8.713 vs.- 22.33±1.638 p = 0.022) and free wall strain (SaV FWS) (-25.956±2.836 vs.- 28.211±2.103 p <0.001) in the post-BMT group were significantly lower than the control group. In the BMT group, compared to the control group, right ventricular ejection fraction (RAV EF)(52.311±2.465 VS 56.601±5.548 p<0.001), right ventricular fractional area change (RAV FAC) (46.27±2.57 vs 51.42± 4.56 p<0.001) values were lower. Conclusion: In this study, we demonstrated that right heart systolic and diastolic functions and pulmonary artery stiffness may be affected in patients undergoing BMT. In this respect, we believe that patients at risk of developing cardiotoxicity associated with BMT treatment and preparation regimen should be evaluated with advanced echocardiographic techniques to initiate preventive and therapeutic approaches. Keywords: Bone marrow transplantation, Hematologic disease, 4B Echocardiography Strain, transthoracic echocardiography