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Association of persistent tachycardia with early myocardial dysfunction in children undergoing allogeneic hematopoietic cell transplantation

Bone Marrow Transplantation volume 56, pages 2544–2554 (2021)Cite this article

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Abstract

Cancer survivors who have undergone hematopoietic cell transplantation (HCT) are at risk for myocardial dysfunction. Children who receive allogenic HCT encounter systemic inflammation resulting in tachycardia and hypertension. The effect of these abnormalities on myocardial function is not known. The aim of this study was to determine whether cardiac dysfunction early after HCT can be predicted by tachycardia or hypertension, within a retrospective single-center sample of pediatric HCT recipients. Early tachycardia or hypertension was defined as a majority of values taken from infusion date to 90 days post-infusion being abnormal. Ejection fraction <53% determined systolic dysfunction. A composite score of accepted pediatric diastolic abnormalities determined diastolic dysfunction. Among 80 subjects (median age 8 years), early tachycardia, systolic dysfunction, and diastolic dysfunction were present in 64%, 25%, and 48% of the sample, respectively. In multivariable models, early tachycardia was an independent predictor of early systolic dysfunction (OR = 12.6 [1.4–112.8], p = 0.024) and diastolic dysfunction (OR = 3.9 [1.3–11.5], p = 0.013). Tachycardia and cardiac dysfunction are common and associated with one another in the early period after pediatric HCT. Future studies may elucidate the role of tachycardia and myocardial dysfunction early after HCT as important predictors of future cardiovascular dysfunction.

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Fig. 1: Five-day average proportions of tachycardia and hypertension in children before and after allogenic HCT.
Fig. 2: Development of Cardiac Dysfunction in the Early Post-HCT Period.

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Authors and Affiliations

  1. Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN, USA

    Jason F. Goldberg, Emily J. Peters, Mazal N. Hagler, Vijaya M. Joshi, Gary S. Beasley, Hugo R. Martinez, Kaitlin A. Ryan, Mohammed A. Absi, Jenny R. Strelsin, Jeffrey A. Towbin & Brandon M. Triplett

  2. Department of Pediatric Medicine, St. Jude Children’s Research Hospital, Memphis, TN, USA

    Jason F. Goldberg, Vijaya M. Joshi, Gary S. Beasley, Hugo R. Martinez, Kaitlin A. Ryan, Mohammed A. Absi, Jenny R. Strelsin & Jeffrey A. Towbin

  3. Department of Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, TN, USA

    Elizabeth A. Tolley, Shelby E. Wallace & Simonne S. Nouer

  4. Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children’s Research Hospital, Memphis, TN, USA

    Brandon M. Triplett

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Goldberg, J.F., Peters, E.J., Tolley, E.A. et al. Association of persistent tachycardia with early myocardial dysfunction in children undergoing allogeneic hematopoietic cell transplantation. Bone Marrow Transplant 56, 2544–2554 (2021). https://doi.org/10.1038/s41409-021-01330-w

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