{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T15:59:20Z","timestamp":1785772760104,"version":"3.56.0"},"reference-count":32,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T00:00:00Z","timestamp":1752710400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Italian Ministry of Health"},{"name":"LILT\u2014Metropolitan City of Turin"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Carfilzomib (CFZ) is a proteasome inhibitor with known cardiotoxic effects used in multiple myeloma (MM) treatment. Cardio-oncology guidelines recommend cardiovascular risk assessment via echocardiography. Left atrial strain (LAS) is not yet included as a marker of cardiotoxicity, but it is emerging as a potential indicator of cardiac dysfunction. Objective: This study evaluates LAS as a predictor of CFZ-related hypertensive cardiovascular adverse events (CVAEs) in MM patients, with or without prior hypertension. Methods: A total of 125 MM patients treated with CFZ at the Hypertension Center, \u201cCitt\u00e0 della Salute e della Scienza\u201d in Turin, were enrolled. Baseline assessments included transthoracic echocardiography for LAS analysis via Philips QLAB software. Results: During CFZ therapy, 52% of patients experienced hypertensive events. LAS conduit was significantly impaired in those who experienced CVAEs (\u221216.20 [\u221220.75; \u221212.65] vs. \u221220.80 [\u221226.30; \u221215.40], p = 0.006) and LAS conduit &gt; \u221222 acted as a predictor of hypertensive adverse events in the normotensive population (OR 2.37 [1.02; 5.50]). Conclusion: These findings indicate that alterations in LAS conduit are linked to an increased risk of hypertensive adverse events during CFZ treatment. Incorporating LAS measurement into cardiovascular risk assessments may improve personalized risk stratification for MM patients, especially those without pre-existing hypertension.<\/jats:p>","DOI":"10.3390\/cancers17142375","type":"journal-article","created":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T11:25:17Z","timestamp":1752751517000},"page":"2375","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Emerging Role of Left Atrial Strain in Cardiovascular Risk Stratification for Multiple Myeloma Patients Undergoing Carfilzomib Therapy"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-2675-8015","authenticated-orcid":false,"given":"Anna","family":"Colomba","sequence":"first","affiliation":[{"name":"Candiolo Cancer Institute, FPO\u2014IRCCS, 10060 Candiolo, TO, Italy"},{"name":"Department of Medical Sciences, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5407-5188","authenticated-orcid":false,"given":"Lorenzo","family":"Airale","sequence":"additional","affiliation":[{"name":"Hypertension Unit, Department of Medical Sciences, Division of Internal Medicine, AOU Citt\u00e0 della Salute e della Scienza University Hospital, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Lasagno","sequence":"additional","affiliation":[{"name":"Candiolo Cancer Institute, FPO\u2014IRCCS, 10060 Candiolo, TO, Italy"},{"name":"Department of Medical Sciences, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Mingrone","sequence":"additional","affiliation":[{"name":"Candiolo Cancer Institute, FPO\u2014IRCCS, 10060 Candiolo, TO, Italy"},{"name":"Department of Medical Sciences, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Astarita","sequence":"additional","affiliation":[{"name":"Hypertension Unit, Department of Medical Sciences, Division of Internal Medicine, AOU Citt\u00e0 della Salute e della Scienza University Hospital, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizio","family":"Vallelonga","sequence":"additional","affiliation":[{"name":"Candiolo Cancer Institute, FPO\u2014IRCCS, 10060 Candiolo, TO, Italy"},{"name":"Department of Medical Sciences, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dario","family":"Leone","sequence":"additional","affiliation":[{"name":"Candiolo Cancer Institute, FPO\u2014IRCCS, 10060 Candiolo, TO, Italy"},{"name":"Department of Medical Sciences, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Sanapo","sequence":"additional","affiliation":[{"name":"Candiolo Cancer Institute, FPO\u2014IRCCS, 10060 Candiolo, TO, Italy"},{"name":"Department of Medical Sciences, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arianna","family":"Paladino","sequence":"additional","affiliation":[{"name":"Candiolo Cancer Institute, FPO\u2014IRCCS, 10060 Candiolo, TO, Italy"},{"name":"Department of Medical Sciences, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Novello","sequence":"additional","affiliation":[{"name":"Candiolo Cancer Institute, FPO\u2014IRCCS, 10060 Candiolo, TO, Italy"},{"name":"Department of Medical Sciences, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4539-6363","authenticated-orcid":false,"given":"Sara","family":"Bringhen","sequence":"additional","affiliation":[{"name":"SSD Clinical Trials in Oncoematologia e Mieloma Multiplo, Division of Oncology, AOU Citt\u00e0 della Salute e della Scienza University Hospital, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8619-412X","authenticated-orcid":false,"given":"Francesca","family":"Gay","sequence":"additional","affiliation":[{"name":"SSD Clinical Trials in Oncoematologia e Mieloma Multiplo, Division of Oncology, AOU Citt\u00e0 della Salute e della Scienza University Hospital, 10126 Turin, Italy"},{"name":"Department of Molecular Biotechnology and Health Sciences, Division of Hematology, University of  Turin, 10124 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6654-6247","authenticated-orcid":false,"given":"Franco","family":"Veglio","sequence":"additional","affiliation":[{"name":"Hypertension Unit, Department of Medical Sciences, Division of Internal Medicine, AOU Citt\u00e0 della Salute e della Scienza University Hospital, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8863-8572","authenticated-orcid":false,"given":"Alberto","family":"Milan","sequence":"additional","affiliation":[{"name":"Candiolo Cancer Institute, FPO\u2014IRCCS, 10060 Candiolo, TO, Italy"},{"name":"Department of Medical Sciences, University of Turin, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1753","DOI":"10.3324\/haematol.2013.089334","article-title":"Integrated safety profile of single-agent carfilzomib: Experience from 526 patients enrolled in 4 phase II clinical studies","volume":"98","author":"Siegel","year":"2013","journal-title":"Haematologica"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2197","DOI":"10.1016\/S0140-6736(14)60493-1","article-title":"Multiple myeloma","volume":"385","author":"Knop","year":"2015","journal-title":"Lancet Lond. 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