CHARACTERISTIC OF CARDIOVASCULAR STATUS AND INTRACARDIAC HEMODYNAMICS IN PATIENTS WITH MULTIPLE MYELOMA BEFORE THE START OF ANTITUMOR THERAPY

Aim To evaluate risk factors, the cardiovascular status, and the condition of intracardiac hemodynamics in patients with multiple myeloma (MM) before the start of specific antitumor treatment. Material and methods The study included 2 groups with equal number of patients: group 1,25 patients newly diagnosed with MM; group 2 (comparison group), 25 patients with documented cardiovascular diseases (CVDs), including arterial hypertension (AH) and ischemic heart disease (IHD). Standard laboratory tests, instrumental studies (electrocardiography, echocardiography, 24-h Holter electrocardiographic monitoring), and analysis of documented CVD risk factors were performed for all included patients. Results Comparison of these two groups showed that the condition of the cardiovascular system (CVS) of patients with MM was comparable with that of patients with documented CVDs. Patients of the main group showed significant, moderate positive correlations between indexes of systemic inflammation, blood lipid composition, and intracardiac hemodynamics, i.e., concentrations of C-reactive protein (CRP) and triglycerides (r=0.415; p<0.05); CRP and very low-density lipoproteins (r=0.345; p=0.09); CRP concentration and left atrial volume (r=0.434; p<0.05); and CRP concentration and end-diastolic volume (r=0.30; p<0.05). The high risk of cardiovascular complications at baseline, in MM patients, may be due to cardiac remodeling associated with active systemic inflammation. Conclusion Considering the use of potentially cardio- and vasculotoxic drugs for the treatment of MM, evaluation of the cardiovascular status and cardio-oncologist/cardiologist consultation with selection of therapy should be a mandatory stage preceding the start of specific treatment.