Haemodynamic Forces: Emerging Markers of Ventricular Remodelling in Multiple Myeloma Cardiovascular Baseline Risk Assessment

Simple Summary: Multiple myeloma (MM) patients are often affected by cardiovascular (CV) diseases, making baseline CV risk evaluation a fundamental step before starting cardiotoxic drug regimens. Haemodynamic forces (HDFs) analysis is the latest technology for the early identification of myocardial damage. We aimed to identify differences in HDFs analysis in patients with MM, hypertension or both versus normotensive non-oncologic subjects. During echocardiography and pulse wave velocity assessment, hypertensive patients showed decreased ejection fraction, global longitudinal strain and HDFs values compared with normotensive non-oncologic patients, whereas ventricular mass and PWV increased. Multiple myeloma normotensive patients displayed a significant reduction in systolic HDFs and systolic ejection HDFs compared with normotensive non-oncologic patients, but no significant change in terms of standard ventricular markers and PWV was found. Therefore, MM leads to ventricular remodelling regardless of hypertension; HDFs act as early markers of subclinical cardiac damage, and we propose HDFs analysis application in normotensive oncologic patients. Multiple myeloma (MM) affects a population with a high prevalence of cardiovascular (CV) disease. These patients benefit from an accurate CV risk evaluation in order to choose the safest drug regimen. Haemodynamic forces (HDFs) analysis allows for the earlier detection of myocardial damage compared with standard markers; the role played by MM in HDFs alteration, with or without the influence of hypertension, is yet to be studied. Therefore, we aimed to identify differences in HDFs analysis in patients with MM, hypertension or both versus normotensive non-oncologic subjects. A total of 173 patients (MM hypertensive patients, MMHT; MM normotensive patients, MMNT; non-oncologic hypertensive patients, CoHT; and non-oncologic normotensive patients, CoNT) underwent transthoracic echocardiography for HDFs analysis and pulse wave velocity (PWV) assessment. Hypertensive patients (MMHT, CoHT) showed decreased ejection fraction (EF), global longitudinal strain (GLS) and HDFs values compared with CoNT, whereas ventricular mass (LVMi) and PWV increased. MMNT displayed a significant reduction in systolic HDFs (p < 0.006) and systolic ejection HDFs (p < 0.008) compared with CoNT, without significant change in EF, GLS, LVMi or PWV. In conclusion, MM leads to ventricular remodelling regardless of hypertension; HDFs application for MM patients could help detect early myocardial damage, especially in patients receiving cardiotoxic drugs.