Myocardial strain is associated with adverse cardiac events in patients treated with chimeric antigen receptor (CAR) T-cell therapy

Nikita P. Patel, Prarthana J. Dalal, Zhiying Meng, Abigail S. Baldridge, Gregory J. Cascino, Ashwin Sunderraj, Arjun Sinha, Reem Karmali, Matthew J. Feinstein, Nausheen Akhter*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: Cardiovascular events, including heart failure and arrhythmias, following chimeric antigen receptor (CAR) T-cell therapy are increasingly recognized. Although global longitudinal strain (GLS) has demonstrated prognostic utility for other cancer therapy-related cardiac dysfunction, less is known regarding the association of GLS with adverse cardiac events following CAR T-cell therapy. Objectives: To determine the association of baseline GLS with adverse cardiovascular events in adults receiving CAR-T cell therapy. Methods: Patients who had an echocardiogram within 6 months prior to receiving CAR T-cell therapy were retrospectively identified. Clinical data and cardiac events were collected via chart review. Echocardiograms were analyzed offline for GLS, left ventricular ejection fraction, and Doppler parameters. Multivariable logistic regression was used to determine the association between adverse cardiovascular events and echocardiographic parameters. Results: Among 75 CAR T-cell therapy patients (mean age 63.9, 34.7% female), nine patients (12%) experienced cardiac events (CEs) including cardiovascular death, new/worsening heart failure, and new/worsening arrhythmia within 1 year of treatment. In univariable models, higher baseline GLS (OR 0.78 [0.63, 0.96], p =.021) was associated with a lower risk of CE and higher baseline mitral E/e' (OR 1.40 [1.08, 1.81], p =.012) was associated with a higher risk of CE. After adjusting for age and LDH, higher baseline GLS (OR 0.65 [0.48–0.88], p = <.01) was associated with a lower risk of CE and higher baseline mitral E/e' (OR 1.56 [1.06, 2.29], p =.024) was associated with a higher risk of CE. Conclusion: Lower GLS and higher mitral E/e' on a baseline echocardiogram were associated with higher risk for CEs in patients receiving CAR T-cell therapy.

Original languageEnglish (US)
Pages (from-to)102-110
Number of pages9
JournalEuropean Journal of Haematology
Volume112
Issue number1
DOIs
StatePublished - Jan 2024

Keywords

  • CAR T-cell
  • cardiac events
  • global longitudinal strain
  • immune therapy

ASJC Scopus subject areas

  • Hematology

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