Author + information
- Wang Chunjian,
- Xue Han,
- Fang Wang,
- Beibei Bai and
- Ye Chen
Myeloproliferative neoplasms are chronic hematopoietic malignancies characterized by a high frequency of cardiovascular events. Its effect on cardiac remodeling and function is still not clear.
Patients with MPN were enrolled in Beijing Anzhen Hospital from Apr 2004 to Apr 2016. The clinic data including age, gender, cardiovascular risk factors, blood counts, blood lipids, echocardiaographic parameters were collected and analyzed. Control group were non-MPN patients, gender and age were matched with MPN patients. No differences of previous history of coronary artery diseases, hypertension or diabetes were found between the two groups. The cardiac parameters of echocardiography assessment were analyzed and compared in patients with MPN or non-MPN.
A total of 86 patients with MPN and without MPN were enrolled respectively, the average age was 61±12.9 years old in MPN patients, 61.5±12.7 in non-MPN patients. There were 57 cases with ET, 26 with PV and 3 with PMF among MPNs. There were no differences in age, gender and medical history including coronary heart disease, dyslipidemia, hypertension, diabetes and smokers between the two groups. The white blood cell, neutrophil, lymphocyte, basophil and platelet counts in MPN group were significantly higher than those in control group (8.9±4.8×109/L vs 6.2±1.9×109/L, P=0.000; 6.2±3.5×109/L vs 3.9±1.3×109/L, P=0.000; 2.0±1 ×109/L vs 1.8±0.7×109/L, P= 0.017; 0.05±0.02×109/L vs 0.026±0.019×109/L, P=0.000; 488.20±261.5×109/L vs 213.4±49.6 ×109/L, P=0.000). Left ventricular diastolic dimension, left atria diameter and right ventricular anterior-posterior diameter in MPN group were significantly higher than that in control group (48.9±5.4mm vs 46.9±5.5mm, P=0.048; 37.8±6.5mm vs 35.3±4.8mm, P=0.006; 21.9±6.0mm vs 20.4±2.6mm, P=0.021). MPN patients with aortic valve thickening was 22 cases (27.9%), with pulmonary artery hypertension (PAH) 10 cases (11.6%). Both patients with aortic valve thickening and PAH were higher than control group [11cases (12.8%), P=0.022; 0 case (0%), P=0.001]. The left ventricular ejection fraction (LVEF) in MPN patients was significantly lower than that in control group (60.0±10.4% vs 63.4±7.2%, p=0.014).
MPN patients are prone to develop cardiac remodeling and dysfunction, especially left atria and ventricular enlargement and decreased ejection fraction, degenerative aortic valve changes as well as PAH. Our results show MPN patients not only associated with high incidence of thrombus events, but also with remodeling and dysfunction of heart.