Superiority of left heart deformation in early anthracycline-related cardiac dysfunction detection
Objective This study aimed to assess the incidence of early cancer therapy-related cardiac dysfunction (CTRCD) and the characteristics of left and right heart deformations during anthracycline chemotherapy.Methods We prospectively enrolled a cohort of 351 chemotherapy-naïve women with breast cancer...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-11-01
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| Series: | Open Heart |
| Online Access: | https://openheart.bmj.com/content/10/2/e002493.full |
| _version_ | 1797366925515292672 |
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| author | Nhat Giang M Hai Nguyen H Duc Tan Vo Tri Ho Huynh Quang Duc Thi Hong Phan Ngoc-Hoa Chau |
| author_facet | Nhat Giang M Hai Nguyen H Duc Tan Vo Tri Ho Huynh Quang Duc Thi Hong Phan Ngoc-Hoa Chau |
| author_sort | Nhat Giang M |
| collection | DOAJ |
| description | Objective This study aimed to assess the incidence of early cancer therapy-related cardiac dysfunction (CTRCD) and the characteristics of left and right heart deformations during anthracycline chemotherapy.Methods We prospectively enrolled a cohort of 351 chemotherapy-naïve women with breast cancer and cardiovascular risk factors who were scheduled to receive anthracycline. The left ventricular ejection fraction (LVEF), left ventricular global longitudinal strain (LV-GLS) and right ventricular and left atrial longitudinal strains were evaluated using echocardiography at baseline, before every subsequent cycles and at 3 weeks after the final anthracycline dose. CTRCD was defined as a new LVEF reduction by ≥10 percentage points to an LVEF<50% and/or a new relative decline in GLS by >15% from the baseline value.Results Eighteen (5.1%) patients had evidence of asymptomatic CTRCD during anthracycline treatment, and 50% developed CTRCD before completing the chemotherapy regimen. In the CTRCD group, while LV-GLS decrease significantly after the first dose of anthracycline, the reduction of right ventricular free-wall longitudinal strain and left atrial reservoir strain were observed after the second dose. Other strain indices could not be used to identify early CTRCD.Conclusions Cardiotoxicity appeared soon after the initiation of anthracycline chemotherapy. Among the left-heart and right-heart mechanics, LV-GLS remains the best deformation indicator for detecting early CTRCD. |
| first_indexed | 2024-03-08T17:11:29Z |
| format | Article |
| id | doaj.art-12c212ce799d47dd9e58ae58e31c7ad6 |
| institution | Directory Open Access Journal |
| issn | 2053-3624 |
| language | English |
| last_indexed | 2024-03-08T17:11:29Z |
| publishDate | 2023-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Open Heart |
| spelling | doaj.art-12c212ce799d47dd9e58ae58e31c7ad62024-01-03T21:35:08ZengBMJ Publishing GroupOpen Heart2053-36242023-11-0110210.1136/openhrt-2023-002493Superiority of left heart deformation in early anthracycline-related cardiac dysfunction detectionNhat Giang M0Hai Nguyen H1Duc Tan Vo2Tri Ho Huynh Quang3Duc Thi Hong Phan4Ngoc-Hoa Chau5Department of Cardiac Intensive Care and Cardiomyopathy, Nhan Dan Gia Dinh Hospital, Ho Chi Minh City, VietnamDepartment of Cardiac Intensive Care and Cardiomyopathy, Nhan Dan Gia Dinh Hospital, Ho Chi Minh City, VietnamDiagnostic Imaging Department, University Medical Center of Ho Chi Minh City, Ho Chi Minh City, VietnamDepartment of Cardiac Intensive Care, Heart Institute, Ho Chi Minh City, VietnamMedical Oncology Department, Ho Chi Minh City Oncology Hospital, Ho Chi Minh, VietnamFaculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, VietnamObjective This study aimed to assess the incidence of early cancer therapy-related cardiac dysfunction (CTRCD) and the characteristics of left and right heart deformations during anthracycline chemotherapy.Methods We prospectively enrolled a cohort of 351 chemotherapy-naïve women with breast cancer and cardiovascular risk factors who were scheduled to receive anthracycline. The left ventricular ejection fraction (LVEF), left ventricular global longitudinal strain (LV-GLS) and right ventricular and left atrial longitudinal strains were evaluated using echocardiography at baseline, before every subsequent cycles and at 3 weeks after the final anthracycline dose. CTRCD was defined as a new LVEF reduction by ≥10 percentage points to an LVEF<50% and/or a new relative decline in GLS by >15% from the baseline value.Results Eighteen (5.1%) patients had evidence of asymptomatic CTRCD during anthracycline treatment, and 50% developed CTRCD before completing the chemotherapy regimen. In the CTRCD group, while LV-GLS decrease significantly after the first dose of anthracycline, the reduction of right ventricular free-wall longitudinal strain and left atrial reservoir strain were observed after the second dose. Other strain indices could not be used to identify early CTRCD.Conclusions Cardiotoxicity appeared soon after the initiation of anthracycline chemotherapy. Among the left-heart and right-heart mechanics, LV-GLS remains the best deformation indicator for detecting early CTRCD.https://openheart.bmj.com/content/10/2/e002493.full |
| spellingShingle | Nhat Giang M Hai Nguyen H Duc Tan Vo Tri Ho Huynh Quang Duc Thi Hong Phan Ngoc-Hoa Chau Superiority of left heart deformation in early anthracycline-related cardiac dysfunction detection Open Heart |
| title | Superiority of left heart deformation in early anthracycline-related cardiac dysfunction detection |
| title_full | Superiority of left heart deformation in early anthracycline-related cardiac dysfunction detection |
| title_fullStr | Superiority of left heart deformation in early anthracycline-related cardiac dysfunction detection |
| title_full_unstemmed | Superiority of left heart deformation in early anthracycline-related cardiac dysfunction detection |
| title_short | Superiority of left heart deformation in early anthracycline-related cardiac dysfunction detection |
| title_sort | superiority of left heart deformation in early anthracycline related cardiac dysfunction detection |
| url | https://openheart.bmj.com/content/10/2/e002493.full |
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