Abstract 14343: Predictive Value of Myocardial Strain for Chimeric Antigen Receptor T-cell Therapy Associated Cardiovascular Events

Introduction: Cardiovascular events following Chimeric Antigen Receptor (CAR) T-cell therapy are increasingly recognized. Left ventricular systolic dysfunction and arrhythmias are the most common cardiac toxicities seen. Thus, cardiac risk stratification in this population is important, especially in adults with subclinical cardiac disease. Although left ventricular global longitudinal strain (LV-GLS) has demonstrated prognostic utility for other cancer therapy related cardiac dysfunction, less is known regarding predictors of adverse cardiac events following CAR T-cell therapy. We determined the association of baseline LV-GLS with adverse cardiovascular events in adults receiving CAR-T cell therapy. Methods: We identified 75 patients who had baseline LV-GLS measurements available within 6 months of initiating CAR T-cell therapy at a large urban medical center from 2016-2020. Demographics, malignancy history, treatment data, cardiovascular risk factors, echocardiographic measurements (LV-GLS and left ventricular ejection fraction (LVEF)), and cardiac events were retrospectively collected via chart review. Absolute value of LV-GLS was used for ease of interpretation. Multivariable logistic regression was used to determine the association of LV-GLS (per 1% rise) with cardiovascular events with adjustment for age, BMI, CAD, HTN, HLD, DM, and previous cardiotoxic chemotherapy. Results & Conclusions: There were 10 CAR T-cell therapy-related cardiac events, including 1 death, 3 new/worsening cardiomyopathies, and 6 new/worsening arrythmias. Higher baseline LV-GLS (per 1% rise in absolute value) was associated with a significantly lower risk of cardiovascular events (OR 0.66, 95% CI 0.46, 0.96). These findings suggest LV-GLS may risk-stratify adults receiving CAR T-cell therapy for therapy-related cardiac toxicity. Additional prospective studies in other cohorts are needed to corroborate these findings.