Reduced exercise capacity is associated with left ventricular systolic dysfunction in long‐term survivors of allogeneic hematopoietic stem‐cell transplantation

PURPOSE: Exercise intolerance is a common complication in survivors of allogeneic hematopoietic stem‐cell transplantation (allo‐HSCT). The aim of this study was to determine if cardiac function measured with echocardiography is associated with exercise capacity measured with cardio‐pulmonary exercise tests in long‐term survivors treated in their youth with allo‐HSCT. METHODS: The study included 96 patients, of which 54.2% were female, aged 34.9 ± 11.6 years and 17.7 ± 9.3 years after allo‐HSCT. Reduced exercise capacity was defined as <85% of predicted‐peak oxygen uptake (VO(2peak)). Linear regression was used in the prediction of VO(2peak) (ml/kg/min). Receiver operating characteristic evaluated the accuracy of predicting reduced exercise capacity. RESULTS: VO(2peak) was 36.2 ± 7.7 ml/kg/min and 43 (44.8%) had reduced exercise capacity. Left ventricular ejection fraction was 55.4 ± 5.9% and global longitudinal strain (GLS) was −17.6% ± 2.0%. Left and right ventricular functions were significantly lower in survivors with reduced exercise capacity. Increased body mass index, lower physical activity score, reduced pulmonary function (by forced expiratory volume in 1‐s) and reduced left ventricular systolic function (by GLS) were significant independent predictors for reduced VO(2peak). GLS was superior to other echocardiographical indices for identifying reduced exercise capacity (area under curve = 0.64, p = 0.014). CONCLUSIONS: Left ventricular systolic dysfunction measured by GLS is associated with reduced exercise capacity in long‐term allo‐HSCT survivors.