P71 | Cardiovascular effects of Bruton’s tyrosine kinase inhibitor in chronic lymphocytic leukemia: an advanced echocardiographic study

V. Gammaldi, M. Pucci, D. Paoletta, L.M. Capece, M. Pontoriero, R. Esposito | Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy

Background: Bruton’s tyrosine kinase (BTK) inhibitors have revolutionized treatment of chronic lymphocytic leukemia (CLL). However, ibrutinib, the first BTK inhibitor approved, is associated with serious toxicities including atrial fibrillation, ventricular arrhythmias, hypertension and heart failure.
Objectives: Aim of the study is to monitor cardiac performance of patients with CLL treated with Ibrutinib using advanced echocardiography during a six-months follow-up.
Methods: Study population includes 26 patients who, before starting treatment and six months later, underwent standard and advanced echocardiographic evaluation including left ventricular global longitudinal strain (GLS), left atrial strain and myocardial work study: global work index (GWI), constructive work (GCW), wasted work (GWW) and work efficiency (GWE).
Results: At follow up evaluation there weren’t statistically significant differences of standard and advanced echocardiographic parameters evaluated, although two patients have developed atrial fibrillation.
Conclusions: The stability of myocardial work parameters with improvement of myocardial efficiency (91.57 vs. 90.42) although not significant, allows us to hypothesize a potential beneficial effect of increased blood pressure on cardiac performance. The stability of the echocardiographic parameters of atrial strain allows us to hypothesize that Ibrutinib doesn’t worsen atrial remodeling, therefore it may not be necessary to interrupt this life-saving therapy, while the basal stratification of the patients before starting treatment remaining fundamental.