Transthoracic Echocardiography
Echocardiographic measurements were obtained according to the American Society of Echocardiography guidelines [12] on GE or Phillips machines. Two blinded reviewers retrospectively analyzed the transthoracic echocardiograms of all patients prior to ibrutinib treatment, obtaining measures of right atrial pressure, right ventricular size (RV size), right ventricular fractional area change, right ventricular systolic pressure, tricuspid regurgitation maximum velocity (TR Vmax), TAPSE, left atrial indexed volume (LAVI), mitral E and A velocity, mitral E/e’, diastolic dysfunction, valvular disease, left ventricular ejection fraction (LVEF) and left ventricular global longitudinal strain (LV GLS). RV size was measured as RV basal diameter at end diastole in the apical 4 chamber view. LAVI was measured using the biplane area-length method. Valvular disease was noted if patients had moderate or severe mitral stenosis, mitral regurgitation, aortic stenosis or aortic regurgitation.