AI Article Synopsis
- Anthracyclines used in chemotherapy can lead to left ventricular dysfunction, but there is limited research on their impact on right ventricular function.
- This study involved 83 women with breast cancer receiving anthracyclines and assessed cardiac function at multiple time points using various echocardiographic techniques.
- The findings revealed significant decreases in both left and right ventricular function following treatment, with 39% of patients showing left ventricular subclinical cardiotoxicity and 28% displaying right ventricular subclinical cardiotoxicity, emphasizing the importance of early detection methods like speckle-tracking echocardiography.
Article Abstract
Background: Anthracyclines can cause left ventricular (LV) dysfunction. There is little data about right ventricular (RV) damage during chemotherapy.
Aim: This study aimed to investigate the toxic effects of chemotherapy, analyzing its impact on right ventricular function.
Material And Methods: A prospective study was conducted, enrolling 83 female patients (55 ± 11 years old) affected by breast cancer treated with anthracyclines. Cardiological evaluation, HFA risk score assessment and comprehensive echocardiogram, including speckle tracking analysis and 3D analysis, were performed before starting chemotherapy (T0) and at 3 (T1), 6 (T2) and 12 months (T3) after beginning treatment. RV function was assessed with tricuspid annular plane excursion (TAPSE), S' wave of the tricuspid annulus, fractional area change (FAC), RV global longitudinal strain (RV-GLS), free wall strain (RV-FWLS) and RV 3D ejection fraction (RV-3DEF). Subclinical LV CTRCD was defined as a reduction of GLS > 15% compared to baseline. Subclinical RV cardiotoxicity was defined as the co-presence of a relative decrease of 10% from baseline in RV-3DEF and a relative reduction of 15% from baseline RV-FWLS.
Results: After chemotherapy, we found a significant reduction in 2D-LVEF (p = < 0.001) and 3D-LVEF (p = < 0.001), in LV-GLS and RVLS (p = < 0.001), in FAC and TAPSE, also RV-3DEF reduced significantly (p = 0.002). 39% of patients developed LV subclinical CTRCD; 28% of patients developed RV subclinical cardiotoxicity. LV and RV changes occurred concomitantly, and no RV echocardiographic parameters were found to predict the development of LV CTRCD and vice-versa.
Conclusion: After anthracyclines-based chemotherapy, LV and RV subclinical damage occurs, and it can be detected early by speckle-tracking and 3D echocardiography.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11017635 | PMC |
| http://dx.doi.org/10.1186/s40959-024-00224-2 | DOI Listing |
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