Differential cardiac impacts of hematological malignancies and solid tumors: a histopathological and biomarker study

Abstract Background Cancer patients are known to be associated with increased risk of cardiovascular disease. However, no studies have examined the differential impact of hematologic malignancies (HMs) and solid tumors (STs) on cardiac morphology at the tissue level. Objective We aimed to examine hi...

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Main Authors: Michael H. Udin, Sunitha Shyam Sunder, Sarmila Nepali, Sharma Kattel, Amr Abdelradi, Scott T. Doyle, Ciprian N. Ionita, Qian Liu, Umesh C. Sharma, Saraswati Pokharel
Format: Article
Language:English
Published: BMC 2024-12-01
Series:Cardio-Oncology
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Online Access:https://doi.org/10.1186/s40959-024-00285-3
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author Michael H. Udin
Sunitha Shyam Sunder
Sarmila Nepali
Sharma Kattel
Amr Abdelradi
Scott T. Doyle
Ciprian N. Ionita
Qian Liu
Umesh C. Sharma
Saraswati Pokharel
author_facet Michael H. Udin
Sunitha Shyam Sunder
Sarmila Nepali
Sharma Kattel
Amr Abdelradi
Scott T. Doyle
Ciprian N. Ionita
Qian Liu
Umesh C. Sharma
Saraswati Pokharel
author_sort Michael H. Udin
collection DOAJ
description Abstract Background Cancer patients are known to be associated with increased risk of cardiovascular disease. However, no studies have examined the differential impact of hematologic malignancies (HMs) and solid tumors (STs) on cardiac morphology at the tissue level. Objective We aimed to examine histopathological features alongside cardiovascular biomarkers in patients with HMs and STs who underwent post-mortem evaluation. Methods We analyzed cardiac changes in 198 patients with HMs and 164 patients with solid tumors STs. We compared demographics, echocardiogram data, exposure to various antineoplastic agents, and post-mortem findings. Additionally, cardiac histological validation was conducted on post-mortem cardiac specimens to examine cardiac tissue morphology, focusing on cardiomyocyte nuclear density, collagen content, and collagen fiber orientation. Results HM patients displayed significantly disordered collagen fiber alignment (0.71 vs 0.83, P = 0.027), and reduced cardiomyocyte nuclear density (56 vs 72, P = 0.002) compared to ST patients. Similarly, hemoglobin level was decreased (6.71 vs 8.06, P < 0.001) in HM patients compared to ST patients. HM patients also showed elevated B-type natriuretic peptide levels (2,275 vs 867, P < 0.001), without significant differences in creatine-kinase MB and cardiac troponin levels. Multivariate analysis identified increased right ventricular thickness, low diastolic blood pressure, and high cardiac troponin levels as risk factors for cardiac death in HM patients. Conclusions This study demonstrates that HM patients have fewer cardiomyocyte nuclei and poorly aligned collagen, with serum biomarker evidence of increased cardiac dysfunction. This supports the necessity for specialized cardiac care for these patients.
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spelling doaj-art-d741ce1104cb4698a1f301b4be0a6e672025-08-20T02:40:18ZengBMCCardio-Oncology2057-38042024-12-0110111710.1186/s40959-024-00285-3Differential cardiac impacts of hematological malignancies and solid tumors: a histopathological and biomarker studyMichael H. Udin0Sunitha Shyam Sunder1Sarmila Nepali2Sharma Kattel3Amr Abdelradi4Scott T. Doyle5Ciprian N. Ionita6Qian Liu7Umesh C. Sharma8Saraswati Pokharel9Department of Pathology and Laboratory Medicine, Roswell Park Comprehensive Cancer CenterDepartment of Pathology and Laboratory Medicine, Roswell Park Comprehensive Cancer CenterDepartment of Pathology and Laboratory Medicine, Roswell Park Comprehensive Cancer CenterDepartment of Medicine, Division of Cardiovascular Medicine, University of MinnesotaDivision of Cardiology, Department of Medicine, School of Medicine and Biomedical Sciences, University at BuffaloDepartment of Biomedical Engineering, University at BuffaloDepartment of Biomedical Engineering, University at BuffaloDepartment of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer CenterDepartment of Medicine, School of Medicine and Biomedical Sciences, University at BuffaloDepartment of Pathology and Laboratory Medicine, Roswell Park Comprehensive Cancer CenterAbstract Background Cancer patients are known to be associated with increased risk of cardiovascular disease. However, no studies have examined the differential impact of hematologic malignancies (HMs) and solid tumors (STs) on cardiac morphology at the tissue level. Objective We aimed to examine histopathological features alongside cardiovascular biomarkers in patients with HMs and STs who underwent post-mortem evaluation. Methods We analyzed cardiac changes in 198 patients with HMs and 164 patients with solid tumors STs. We compared demographics, echocardiogram data, exposure to various antineoplastic agents, and post-mortem findings. Additionally, cardiac histological validation was conducted on post-mortem cardiac specimens to examine cardiac tissue morphology, focusing on cardiomyocyte nuclear density, collagen content, and collagen fiber orientation. Results HM patients displayed significantly disordered collagen fiber alignment (0.71 vs 0.83, P = 0.027), and reduced cardiomyocyte nuclear density (56 vs 72, P = 0.002) compared to ST patients. Similarly, hemoglobin level was decreased (6.71 vs 8.06, P < 0.001) in HM patients compared to ST patients. HM patients also showed elevated B-type natriuretic peptide levels (2,275 vs 867, P < 0.001), without significant differences in creatine-kinase MB and cardiac troponin levels. Multivariate analysis identified increased right ventricular thickness, low diastolic blood pressure, and high cardiac troponin levels as risk factors for cardiac death in HM patients. Conclusions This study demonstrates that HM patients have fewer cardiomyocyte nuclei and poorly aligned collagen, with serum biomarker evidence of increased cardiac dysfunction. This supports the necessity for specialized cardiac care for these patients.https://doi.org/10.1186/s40959-024-00285-3CardiotoxicityCancerCancer therapyHematological malignancySolid tumorHeart failure
spellingShingle Michael H. Udin
Sunitha Shyam Sunder
Sarmila Nepali
Sharma Kattel
Amr Abdelradi
Scott T. Doyle
Ciprian N. Ionita
Qian Liu
Umesh C. Sharma
Saraswati Pokharel
Differential cardiac impacts of hematological malignancies and solid tumors: a histopathological and biomarker study
Cardio-Oncology
Cardiotoxicity
Cancer
Cancer therapy
Hematological malignancy
Solid tumor
Heart failure
title Differential cardiac impacts of hematological malignancies and solid tumors: a histopathological and biomarker study
title_full Differential cardiac impacts of hematological malignancies and solid tumors: a histopathological and biomarker study
title_fullStr Differential cardiac impacts of hematological malignancies and solid tumors: a histopathological and biomarker study
title_full_unstemmed Differential cardiac impacts of hematological malignancies and solid tumors: a histopathological and biomarker study
title_short Differential cardiac impacts of hematological malignancies and solid tumors: a histopathological and biomarker study
title_sort differential cardiac impacts of hematological malignancies and solid tumors a histopathological and biomarker study
topic Cardiotoxicity
Cancer
Cancer therapy
Hematological malignancy
Solid tumor
Heart failure
url https://doi.org/10.1186/s40959-024-00285-3
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