Patient With Chronic Myeloid Leukemia on Imatinib With Asymptomatic LV Dysfunction
A 39-year-old woman with chronic myeloid leukemia is referred to the cardio-oncology clinic for cardiovascular assessment and surveillance while receiving a tyrosine kinase inhibitor. She was diagnosed with chronic myeloid leukemia about 10 years ago. Her chronic myeloid leukemia was treated with imatinib, and she has been on imatinib since then with deep molecular response (>4-4.5 log reduction). She is asymptomatic from the cardiovascular perspective and has no cardiovascular risk factors. On physical examination, she is hemodynamically stable and without focal clinical findings. An electrocardiogram shows normal sinus rhythm with normal PR, QRS, and QTc. A transthoracic echocardiogram is ordered because of long-term exposure to imatinib to assess left ventricular (LV) function. The echocardiogram reveals normal biventricular and biatrial dimensions, LV hypertrophy, LV ejection fraction = 45%, grade I diastolic dysfunction, and small pericardial effusion. The rest of the study was unremarkable. Cardiac magnetic resonance imaging (MRI) is requested, which shows LV hypertrophy, LV ejection fraction = 45%, small pericardial effusion, and diffuse sub-endocardial late gadolinium enhancement of LV as well as left atrium.
Which of the following statements is correct?