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Chemotherapy induced cardiotoxicity. The role of right ventricle.

Session Poster Session 1

Speaker Evangelos Oikonomou

Event : Heart Failure 2019

  • Topic : heart failure
  • Sub-topic : Cardiotoxicity of Drugs and Other Therapies
  • Session type : Poster Session

Authors : E Oikonomou (Athens,GR), M Anastasiou (Athens,GR), G Siasos (Athens,GR), F Zagouri (Athens,GR), A Antonopoulos (Athens,GR), S Tsalamandris (Athens,GR), G Vogiatzi (Athens,GR), A Bamias (Athens,GR), MA Dimopoulos (Athens,GR), D Tousoulis (Athens,GR)

Authors:
E Oikonomou1 , M Anastasiou1 , G Siasos1 , F Zagouri2 , A Antonopoulos1 , S Tsalamandris1 , G Vogiatzi1 , A Bamias2 , MA Dimopoulos2 , D Tousoulis1 , 1Hippokration Hospital, University of Athens, 1st Department of Cardiology - Athens - Greece , 2Alexandra University Hospital, Department of Clinical Therapeutics, University of Athens Medical School - Athens - Greece ,

Citation:

Background: Cardiac dysfunction, impairment of left ventricle ejection fraction (LVEF) and heart failure symptoms may developed in patients following antineoplastic treatment for breast cancer. Several risk factors have been associated with increased risk of cardio-toxicity. The prognostic role of right ventricle performance has not been tested.

Purpose: To examine the prognostic role of right ventricle performance in the development of left ventricle dysfunction and cardiotoxicity.

Methods: We enrolled 25 female patients (58±12 y) diagnosed with breast cancer and scheduled for anthracycline-based chemotherapy. Patients were treated with epirubicin(75mg/m2) and cyclophosphamide followed by docetaxel and trastuzumab. A transthoracic echocardiogram was performed at baseline, 3 and 6 months after chemotherapy initiation to evaluate LVEF with Simpson’s rule and right ventricle systolic performance by measurement of the tissue systolic velocity of the right ventricle free wall (SRV).

Results: At baseline the mean LVEF was (62±5%) and the SRV 14.66±4.33cm/sec. Compared to baseline at the 6 months follow up study there was a significant reduction in LVEF (57±6%, p=0.04) while SRV has not change (14.33±4.61cm/sec, p=0.72).  In 7 out of 25 patients there was a clinically significant decrease in LVEF at the 6 months follow up study of more than 5% compared to baseline study. Interestingly, compared to subjects with no change in LVEF, subjects with a decrease in LVEF at the 6 months follow up study had significant lower values of SRV at baseline evaluation (16.5±4.03cm/sec vs. 11.6±2.88cm/sec, p=0.02).

Conclusions: In the present study we found an association between baseline right ventricle systolic performance as it is expressed by SRV and development of chemotherapy induced cardiotoxicity with reduction in left ventricle ejection fraction.

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