QTc Interval Prolongation, Decreased Total Atrial Conduction Time, and Increased Pro-BNP Levels Associated with Immune Checkpoint Inhibitors: An Observational, Prospective, Surveillance Study
Canan Karan1, Ipek Buber2, Cihan Ilyas Sevgican2, Arzu Yaren3, Ismail Dogu Kıilic21Department of Oncology, Gaziantep Liv Hospital, Gaziantep, Türkiye, 2Department of Cardiology, Pamukkale University Faculty of Medicine, Denizli, Türkiye, 3Department of Oncology, Pamukkale University Faculty of Medicine, Denizli, Türkiye
Objectives: We aimed to investigate potential cardiotoxic effects in patients with cancer treated with PD-1/PD-L1 inhibitors. Methods: In this prospective observational cohort study, 52 cancer patients received immunotherapy in a tertiary care hospital. After elimination, 33 patients underwent at least two evaluations, and their examinations were analyzed. The electrocardiographic and echocardiographic assessment was performed on the first visit before ICI administration and three months after treatment. Results: The mean age was 62 years. Thirty patients were at the metastatic stage. Most patients had non-small cell lung cancer, and 84% of patients had received anti-cancer treatment previously. Pro-BNP levels were higher in the post-treatment period (273.13±56.15 pg/mL vs. 812.32±419.1pg/mL; p=0.034; pre- and post-treatment, respectively). For Left ventricular stroke volume (LVSV) and cardiac output (CO) were lower in the post-treatment period (for LVSV: 61.19±13.72 mL vs. 57.80±10.15 mL; p=0.049; for CO: 5.00±1.14 L/min vs. 4.69±0.85 L/min, p=0.048). QTc interval was prolonged post-treatment period (433.57±26.19 msec vs. 451.86±39.41 msec; p=0.029; pre- and post-treatment, respectively). Total atrial conduction time was shorter in the post-treatment period (106.87±17.76 msec vs. 101.19±14.74 msec; p = 0.009; pre- and post-treatment, respectively). Conclusion: Increased pro-BNP levels, prolonged QTc interval, and decreased total atrial conduction time were observed at short-term follow-up after ICI treatment. Keywords: Diastolic function, elevated pro-BNP, immune checkpoint inhibitors, systolic function, QTc prolongation
Cite This Article
Karan C, Buber I, Sevgican C, Yaren A, Kıilic I. QTc Interval Prolongation, Decreased Total Atrial Conduction Time, and Increased Pro-BNP Levels Associated with Immune Checkpoint Inhibitors: An Observational, Prospective, Surveillance Study. EJMI. 2025; 9(2): 64-71
Corresponding Author: Canan Karan