Association between left ventricular function and paraprotein type in patients with multiple myeloma.
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-κ/-λ) 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-λ (log-λ) 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-λ 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-λ 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.
['Yi|Jeong-Eun|JE|', 'Lee|Sung-Eun|SE|', 'Jung|Hae-Ok|HO|', 'Min|Chang-Ki|CK|', 'Youn|Ho-Joong|HJ|']
D000368:Aged D004452:Echocardiography D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D009101:Multiple Myeloma D009194:Myeloma Proteins D012189:Retrospective Studies D016277:Ventricular Function, Left
Multiple myeloma Serum monoclonal paraprotein Ventricular function, left