Moderate-Dose Doxorubicin Does Not Affect Right Ventricular Size or Function Parameters in Lymphoma Patients - A Single-Center Study

Abstract Background and Aims We sought to determine whether doxorubicin affected echocardiographic parameters of right ventricular (RV) size and function when compared with guideline defined values in patients with lymphoma. Methods We enrolled 356 patients with lymphoma from 2013 to 2020. Patients received a mean (SD) of 5.12 (1.48) chemotherapy cycles and a cumulative, body surface area–adjusted doxorubicin dosage of 243.6 (79.6) mg/m2. Echocardiographic assessments occurred at 3 time points: T0, baseline; T1, 3 to 6 months after starting doxorubicin (mean [SD], 5.1 [1.2] months); and T2, 6 to 18 months (mean [SD], 12.98 [2.6] months) after treatment. Results End-diastolic area remained unchanged (P=.12). End-systolic area increased from 10.55 cm2 at T0 to 11.41 cm2 at T1 and 11.32 cm2 at T2 (P<.001). Fractional area change decreased from 46.67% at T0 to 44.35% at T1 and 44.40% at T2 (P=.003). Tricuspid annular plane systolic excursion decreased from 23.17 (4.14) mm to 22.39 (4.10) mm at T1, and 22.13 (3.88) mm at T2 (P=.006). S′ declined from 0.14 m/s at T0 to 0.13 m/s at T1 and T2 (P<.001). Tricuspid regurgitant velocity (P=.58) and RV systolic pressure (P=.75) showed nonsignificant changes. RV free wall strain worsened from −26.29% at T0 to −25.37% at T2 (P=.001). All parameters remained within guideline defined values (p<0.001). No significant differences were noted across dosage groups: <200, 200-300, and >300 mg/m2. Conclusions Echocardiography derived parameters of right ventricular size and function remained within normal guideline-defined values throughout a follow-up of up to 12.98±2.6 months.