Clinical analysis of multiple myeloma with heart failure as initial manifestations / 中国实用内科杂志

ABSTRACT

Objective To explore the clinical feature and prognosis of multiple myeloma with heart failure as initial manifestations.Methods 12 patients of multiple myeloma with heart failure as initial manifestations were analyzed and followed up.Results Twelve patients,9 men and 3 women,with mean age of 48～69(58.4?5.2)years older were enrolled.The first symptoms of the patients were almost the same,with different degree of dyspnea and tachypnea.Anaemia and proteinuria were 83.3% and 75% respectively in 12 patients.ECG showed that 8 patients had low voltage in the limb leads,with present poor R wave progression in the precordial leads and ST-T changes in 6 patients.UCG showed that 10 patients had enlarged left atrium(41.6?4.2)mm,8 patients had increased thickness of the interventricular septums and left ventricular walls as well as diffuse weakness of the wall motion.Followed up for(4.0?3.7)months,all of the patients(100%)died.Conclusion Multiple myeloma with heart failure as initial manifestations is rare clinically,but has fast aggravation and bad prognosis.Pro-brain natriuretic peptide(Pro-BNP)and cardiac troponin are subtile markers for judging the prognosis of patients with multiple myeloma.