Journal of Solid Tumors
Detection of subclinical left ventricular systolic dysfunction by echocardiography in patients receiving anthracyclines: A prospective cohort study
Abstract
Objective: Early cardiac structural and functional changes after chemotherapy are significant challenges when treating cancer patients. The aim of this study is the early detection of sub-clinical myocardial systolic depressed functions by echocartography among patients receiving anthracyclines (postoperative chemotherapy).
Methods: Early picking up subclinical left ventricular systolic dysfunction by echocardiography (TTE) among patients who had been treated with anthracycline chemotherapy 18 and 3 months before. The study included eighty patients. We reported measurements of left ventricular ejection fractions (LVEF), fractional shortening (FS), mitral annular plane systolic excursion (MAPSE) and global longitudinal strain (GLS). Pre-chemotherapy 3, 6 and 18 months after complete doses of anthracyclines were mearsured.
Results: This current prospective cohort study included 80 patients: 8 men (10%), 72 women (90%), with a mean age of 51.95 ± 13.69 years. Number of cycles ranged between 4 and 6 cycles of one of the anthracyclines. Mean heart rate was 76 beats/ minute, mean systolic blood pressure was 118, and mean diastolic blood pressure was 77.5 mmHg. The mean baseline FS was 32.40% ± 5.11%, which significantly decreased to 29.45% ± 5.78% and 26.75% ± 6.85% after 3 and 18 months, respectively. Mean three-dimensional echocardiography measures ejection fraction (3D-EF): Baseline was 61.08% ± 3.62% which was significantly depressed to 58.30% ± 5.54% after 3 months. The mean baseline MAPSE was 13.35 ± 1.35 mm, but it was reduced to 12.69 ± 1.92 mm and 12.60 ± 2.46 mm after 3 and 6 months, respectively. Mean baseline GLS was –17.62 ± 1.32% but reduced to –16.54 ± 2.42%, –15.35 ± 2.64% after 3 and 6 months respectively. By univariate analysis, significant parameters that showed abnormal outcome after 18 months were: gender, ejection fraction (EF), end-diastolic volume of the left ventricle (EDV), end-systolic volume of the left ventricle (ESV), 3D-EF (%), but by multivariate analysis, only EF (%) was significantly correlated with the outcome.
Conclusions: Evaluation of myocardial deformation and functional capacity improved early sub-clinical diagnosis of chemotherapyinduced cardiac toxicity. GLS and MAPSE are much more sensitive as predictors for early deterioration of left ventricular functions.
Methods: Early picking up subclinical left ventricular systolic dysfunction by echocardiography (TTE) among patients who had been treated with anthracycline chemotherapy 18 and 3 months before. The study included eighty patients. We reported measurements of left ventricular ejection fractions (LVEF), fractional shortening (FS), mitral annular plane systolic excursion (MAPSE) and global longitudinal strain (GLS). Pre-chemotherapy 3, 6 and 18 months after complete doses of anthracyclines were mearsured.
Results: This current prospective cohort study included 80 patients: 8 men (10%), 72 women (90%), with a mean age of 51.95 ± 13.69 years. Number of cycles ranged between 4 and 6 cycles of one of the anthracyclines. Mean heart rate was 76 beats/ minute, mean systolic blood pressure was 118, and mean diastolic blood pressure was 77.5 mmHg. The mean baseline FS was 32.40% ± 5.11%, which significantly decreased to 29.45% ± 5.78% and 26.75% ± 6.85% after 3 and 18 months, respectively. Mean three-dimensional echocardiography measures ejection fraction (3D-EF): Baseline was 61.08% ± 3.62% which was significantly depressed to 58.30% ± 5.54% after 3 months. The mean baseline MAPSE was 13.35 ± 1.35 mm, but it was reduced to 12.69 ± 1.92 mm and 12.60 ± 2.46 mm after 3 and 6 months, respectively. Mean baseline GLS was –17.62 ± 1.32% but reduced to –16.54 ± 2.42%, –15.35 ± 2.64% after 3 and 6 months respectively. By univariate analysis, significant parameters that showed abnormal outcome after 18 months were: gender, ejection fraction (EF), end-diastolic volume of the left ventricle (EDV), end-systolic volume of the left ventricle (ESV), 3D-EF (%), but by multivariate analysis, only EF (%) was significantly correlated with the outcome.
Conclusions: Evaluation of myocardial deformation and functional capacity improved early sub-clinical diagnosis of chemotherapyinduced cardiac toxicity. GLS and MAPSE are much more sensitive as predictors for early deterioration of left ventricular functions.
Full Text:
PDFDOI: https://doi.org/10.5430/jst.v15n1p53
Journal of Solid Tumors
ISSN 1925-4067(Print) ISSN 1925-4075(Online)
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