{
  "abstract": "Introduction Azacitidine, a DNA methylation inhibitor, is commonly used for treating myelodysplastic syndromes (MDS) and acute myeloid leukaemia (AML). There is conflicting evidence regarding its impact on cardiac structure and function. While case reports suggest a link between azacitidine and left ventricular (LV) dysfunction, preclinical studies propose cardioprotective effects, including anti-hypertrophic properties. This retrospective analysis aimed to assess the possible impact of azacitidine on cardiac structure and function, evaluated by echocardiography, in patients undergoing treatment for haematological malignancies.Methods A retrospective analysis was conducted on patients treated with azacitidine at Belfast City Hospital Cancer Centre between April 2022 and April 2024. Echocardiograms taken before and after treatment were analysed. Continuous variables were assessed using the Wilcoxon matched-pairs signed rank test, analysed with GraphPad PRISM, Version 10.4.1.Results Among 56 patients treated with azacitidine, 13 were excluded due to missing echocardiogram data, leaving 43 patients (72% male, mean age 66.4 ± 6.6 years). Diagnoses included 78.6% AML, 10.1% MDS, and 11.3% other haematologic disorders. The median duration between baseline and follow-up echocardiograms was 11 months. No change in LV ejection fraction was observed (baseline 58.5% ± 7.6%, follow-up 57.1% ± 6.8%, p=0.18), figure 1A. In a subgroup of patients with elevated indexed LV mass at baseline (n=14), a reduction in indexed LV mass was observed [mean from 116 g/m2 to 103 g/m2 (p=0.03)], figure 1B.Conclusion This retrospective analysis provides insight into the cardiac effects of azacitidine in patients with haematological malignancies. While no change in LV ejection fraction was observed, a reduction in indexed LV mass was identified in a subset of patients, suggesting possible cardiac anti-hypertrophic effects of azacitidine. Larger, prospective studies are required to validate and further explore these findings and any clinical implications.A LV Ejection Fraction B Indexed LV MassAbstract 44 Figure 1Bar graphs showing wilcoxon matched-pairs signed rank test prior to treatment with azacitidine for haematological malignancy and following at least one dose of azacitidine therapy. (A) LV Ejection fraction with no change before and after treatment, did not meet statistical significance p= 0.18. (B) reduction in indexed LV mass observed in those with elevated LV mass prior to treatment with azacitidine (p=0.03)",
  "authors": [
    {
      "affiliations": [
        "Belfast City Hospital, Belfast, Ireland"
      ],
      "name": "M Todd"
    },
    {
      "affiliations": [
        "Royal Victoria Hospital, Belfast, UK"
      ],
      "name": "M Boyd"
    },
    {
      "affiliations": [
        "Royal Victoria Hospital, Belfast, UK"
      ],
      "name": "L Dixon"
    },
    {
      "affiliations": [
        "Queens University Belfast, Belfast, UK"
      ],
      "name": "C Watson"
    }
  ],
  "title": "44 Impact of azacitidine on cardiac function: a retrospective analysis of left ventricular systolic function and myocardial mass using echocardiography",
  "uid": "e2e9b681-1d35-56c3-aa49-063728ee822d"
}