Role of HDL cholesterol in anthracycline-induced subclinical cardiotoxicity: a prospective observational study in patients with diffuse large B-cell lymphoma treated with R-CHOP

作者全名：Ou, Wenxin; Jiang, Tiantian; Zhang, Nan; Lu, Kai; Weng, Yue; Zhou, Xi; Wang, Dong; Dong, Qian; Tang, Xiaoqiong

作者地址：[Ou, Wenxin; Jiang, Tiantian; Weng, Yue; Zhou, Xi; Tang, Xiaoqiong] Chongqing Med Univ, Dept Hematol, Affiliated Hosp 1, Chongqing, Peoples R China; [Zhang, Nan; Lu, Kai; Dong, Qian] Chongqing Med Univ, Dept Cardiol, Affiliated Hosp 1, Chongqing 400016, Peoples R China; [Wang, Dong] Chongqing Med Univ, Dept Ultrasound, Affiliated Hosp 1, Chongqing, Peoples R China

通信作者：Tang, XQ (通讯作者)，Chongqing Med Univ, Dept Hematol, Affiliated Hosp 1, Chongqing, Peoples R China.; Dong, Q (通讯作者)，Chongqing Med Univ, Dept Cardiol, Affiliated Hosp 1, Chongqing 400016, Peoples R China.

来源：BMJ OPEN

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001238806500056

JCR分区：Q1

影响因子：2.4

年份：2024

卷号：14

期号：2

开始页：　

结束页：　

文献类型：Article

关键词：Lymphoma; CHEMOTHERAPY; CARDIOLOGY; Echocardiography

摘要：Objectives Anthracycline-induced cardiotoxicity is a debilitating cardiac dysfunction for which there are no effective treatments, making early prevention of anthracycline-induced subclinical cardiotoxicity (AISC) crucial. High-density lipoprotein cholesterol (HDL-C) plays a role in cardioprotection, but its impact on AISC remains unclear. Our study aims to elucidate the protective capacity of HDL-C in AISC in patients with diffuse large B-cell lymphoma (DLBCL) treated with R-CHOP (cyclophosphamide, vincristine, doxorubicin, prednisone and rituximab).Design Prospective observational study.Setting Conducted in China from September 2020 to September 2022.Participants 70 chemotherapy-naive patients newly diagnosed with DLBCL who were scheduled to receive the standard dose of R-CHOP; 60 participants included in a case-control study (DOI: 10.1186/s12885-022-10085-6).Primary outcome measures Serum biomarkers, 2D speckle tracking echocardiography and conventional echocardiography were measured at baseline, at the end of the third and sixth cycles of R-CHOP and 6 and 12 months after chemotherapy.Results 24 patients experienced AISC, while 10 did not. 36 patients were lost to follow-up and death. Cox regression analysis showed that higher levels of HDL-C were associated with a significantly lower risk of AISC (unadjusted HR=0.24, 95% CI 0.09 to 0.67, p=0.006; adjusted HR=0.27, 95% CI 0.09 to 0.79, p=0.017). Patients without AISC had a more stable and higher HDL-C level during the follow-up period. HDL-C levels significantly decreased from the end of the third cycle of chemotherapy to the end of the sixth cycle of chemotherapy in all patients (p=0.034), and particularly in the AISC group (p=0.003). The highest level of HDL-C was significantly higher in patients without AISC than in those with AISC (1.52 +/- 0.49 vs 1.22 +/- 0.29, p=0.034).Conclusions Our study suggests that higher HDL-C levels may associate with lower AISC risk in patients with DLBCL treated with R-CHOP. HDL-C could be a cardioprotective target, but further research is needed to confirm its benefits and limitations.Study registration number Study registration number: ChiCTR2100054721

基金机构：Science-Health Joint Medical Scientific Research Project of Chongqing 'Study of antineoplastic drugs induced early cardiotoxicity in patients with Lymphoma' [2021MSXM276]; Natural Science Foundation of Chongqing 'The mechanism of doxorubicin promoting atherosclerosis in lymphoma patients through NF-kappaB/miR-33 signaling pathway' [cstc2019jcyj-msxmX0043]; Science-Health Joint Medical Scientific Research Project of Chongqing 'Evaluation of cardiac function in patients with anthracycline chemotherapy by a new strain imaging technique' [2019ZDXM033]; Chongqing Postgraduate Scientific Research and Innovation Project 'Study on the role of high-density lipoprotein in anthracycline-induced subclinical cardiotoxicity in patients with lymphoma' [CYS22340]

基金资助正文：This research was funded by the Science-Health Joint Medical Scientific Research Project of Chongqing 'Study of antineoplastic drugs induced early cardiotoxicity in patients with Lymphoma' (grant number: 2021MSXM276), the Natural Science Foundation of Chongqing 'The mechanism of doxorubicin promoting atherosclerosis in lymphoma patients through NF-kappa B/miR-33 signaling pathway' (grant number: cstc2019jcyj-msxmX0043), the Science-Health Joint Medical Scientific Research Project of Chongqing 'Evaluation of cardiac function in patients with anthracycline chemotherapy by a new strain imaging technique' (grant number: 2019ZDXM033) and the Chongqing Postgraduate Scientific Research and Innovation Project 'Study on the role of high-density lipoprotein in anthracycline-induced subclinical cardiotoxicity in patients with lymphoma' (grant number: CYS22340).