The Korean journal of internal medicine

  • 제32권3호
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  • Pages.459-468
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  • 2017
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  • 1226-3303(pISSN)
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  • 2005-6648(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
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Association between left ventricular function and paraprotein type in patients with multiple myeloma

  • Yi, Jeong-Eun (Department of Internal Medicine, Ewha Womans University Mokdong Hospital) ;
  • Lee, Sung-Eun (Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Jung, Hae-Ok (Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Min, Chang-Ki (Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Youn, Ho-Joong (Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea)
  • 투고 : 2015.11.01
  • 심사 : 2015.11.18
  • 발행 : 2017.05.01
⟨ 이전 논문 다음 논문 ⟩

초록

Background/Aims: Multiple myeloma (MM)-associated cardiac damage, particularly according to the type of monoclonal (M) protein has not been elucidated. We sought to investigate relationship between elevated serum M protein levels and echocardiographic indices of cardiac structure and function in patients with MM. Methods: We evaluated a total of 184 consecutive MM patients who underwent echocardiography for bone marrow pre-transplant screening. Serum levels of intact immunoglobulin M protein and free light chain kappa/lambda ($FLC-{\kappa}/-{\lambda}$) were measured. Results: One hundred thirty-nine patients were non-light chain MM (non-LCMM) and 45 patients belonged to LCMM. In patients with non-LCMM, significant correlations were found between serum M protein and left atrial volume index (LAVi; r = 0.720, p < 0.0001), E/e' (r = 0.511, p < 0.0001), and systolic pulmonary arterial pressure (r = 0.485, p < 0.0001). In patients with LCMM, log-transformed $FLC-{\lambda}$ (${\log}-{\lambda}$) was correlated with left ventricular ejection fraction (LVEF, r = -0.536, p = 0.010), left ventricular (LV) end-systolic dimension (r = 0.500, p = 0.018), and LV end-systolic volume (r = 0.444, p = 0.038). On multivariate analyses, hematocrit and serum M protein were independent predictors of LAVi in patients with non-LCMM. In patient with LCMM, $FLC-{\lambda}$ isotype was only found to be an independent determinant of LVEF. Conclusions: An increase in serum M protein was associated with LV diastolic dysfunction, whereas an increase in serum $FLC-{\lambda}$ concentration showed a negative correlation with the echocardiographic parameters of LV systolic function. These findings also suggest that serum M protein has different effects on LV function according to the type of paraproteins in patients with MM.

키워드

과제정보

연구 과제 주관 기관 : Ministry of Health and Welfare

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피인용 문헌

  1. Capillary electrophoresis analysis of N‐glycosylation changes of serum paraproteins in multiple myeloma vol.38, pp.17, 2017, https://doi.org/10.1002/elps.201700006