One in ten long term lymphoma survivors had heart failure, whereas more than one in five had valvular disease. High doses of chemotherapy and radiation were linked to damage on the heart.
Chemotherapy was not associated with impaired heart function among 74 Norwegian long-term ovarian cancer survivors, even among the women who received the highest doses. However, among lymphoma survivors, PhD candidate Klaus Murbræch and colleagues at the University of Oslo found increased risk of impairments in both the function of the left and right ventricle. In addition, as many as one in five patients had damaged heart valves.
In his work Murbræch examined the heart function of 274 Norwegian adults who survived lymphoma between 1987 and 2008. He compared the results with participants from the HUNT Study, by matching a former cancer patient one-to-one with a healthy person to ensure the characteristics (age, sex, blood pressure and BMI) in the two groups were as similar as possible.
The results indicate impaired systolic heart function in almost one in six lymphoma survivors, seven times more frequent than in the control group. One in ten cancer survivors were diagnosed with heart failure. High chemotherapy and radiation doses were independent risk factors for impaired left ventricular systolic function.
All echocardiographic measurements of right ventricular systolic function were impaired in the cancer group compared to the control group. Impairments were greater in patients who had received high doses of radiation. Still, significantly reduced pump function was far less common than on the left side of the heart.
Finally, 22 % of lymphoma survivors had damages to one or more of the heart valves. A novel finding is that the risk was tripled after treatment with chemotherapy compared to people who have not had cancer.
Thesis: Cardiovascular status in long term survivors of lymphomas and malignant ovarian germ cell tumors
Candidate: Klaus Murbræch
Time and place: February 2, 2017, University of Oslo
Murbraech, K., Smeland, K. B., Holte, H., Loge, J. H., Lund, M. B., Wethal, T., Holte, E., Rösner, A. Dalen, H., Kvaløy, S., Falk, R. S., Aakhus, S. & Kiserud, C. E. (2015). Heart Failure and Asymptomatic Left Ventricular Systolic Dysfunction in Lymphoma Survivors Treated With Autologous Stem-Cell Transplantation: A National Cross-Sectional Study. Journal of Clinical Oncology, 33(24), 2683-2691.
Murbraech, K., Solheim, O., Aulie, H. M., Fossa, S. D., & Aakhus, S. (2015). The impact of cisplatinum‐based chemotherapy on ventricular function and cardiovascular risk factors in female survivors after malignant germ cell cancer. ESC Heart Failure, 2(3), 142-149.
Murbraech, K., Wethal, T., Smeland, K. B., Holte, H., Loge, J. H., Holte, E., Rösner, A., Dalen, H., Kiserud, C. E. & Aakhus, S. (2016). Valvular dysfunction in lymphoma survivors treated with autologous stem cell transplantation: a national cross-sectional study. JACC: Cardiovascular Imaging, 9(3), 230-239.
Murbraech, K., Holte, E., Broch, K., Smeland, K. B., Holte, H., Rösner, A., Lund, M. B., Dalen, H., Kiserud, C. & Aakhus, S. (2016). Impaired Right Ventricular Function in Long-Term Lymphoma Survivors. Journal of the American Society of Echocardiography