Electrocardiographic characteristics of bladder cancer patients receiving preoperative chemotherapy combined with immunotherapy
Abstract Objective Patients treated with preoperative chemotherapy and immunotherapy for bladder cancer may be at increased risk of cardiotoxicity and electrophysiological abnormalities. This study aimed to analyze their electrocardiographic (ECG) alterations. Methods Patients with bladder cancer wh...
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| Format: | Article |
| Language: | English |
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Wiley
2024-01-01
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| Series: | Annals of Noninvasive Electrocardiology |
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| Online Access: | https://doi.org/10.1111/anec.13107 |
| _version_ | 1827368782667972608 |
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| author | Zi‐Liang Chen Kai‐Peng Jia Yi Zheng Nan Zhang Xin Wang Gary Tse Zhi‐Wei Zhang Hai‐Long Hu Tong Liu |
| author_facet | Zi‐Liang Chen Kai‐Peng Jia Yi Zheng Nan Zhang Xin Wang Gary Tse Zhi‐Wei Zhang Hai‐Long Hu Tong Liu |
| author_sort | Zi‐Liang Chen |
| collection | DOAJ |
| description | Abstract Objective Patients treated with preoperative chemotherapy and immunotherapy for bladder cancer may be at increased risk of cardiotoxicity and electrophysiological abnormalities. This study aimed to analyze their electrocardiographic (ECG) alterations. Methods Patients with bladder cancer who were hospitalized and receiving tislelizumab plus nab‐paclitaxel (TnP) were enrolled prospectively. ECG, cardiac biomarkers, and echocardiography were performed at baseline and the end of TnP. Results A total of 60 patients (76.7% males), including 30 muscle‐invasive and 30 non‐muscle‐invasive bladder cancer, received three or four cycles of TnP, respectively. Hypertension was the commonest comorbidity (41.7%), and 25 patients (41.7%) were prescribed cardiovascular drugs. In comparison with baseline characteristics, cardiac troponin I (cTnI) and N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) were within normal ranges after TnP. However, echocardiographic parameter of left ventricular ejection fraction slightly decreased after TnP (62.81 ± 3.81% to 61.10 ± 4.37%, p = .011). The incidence of abnormal ECG increased from 65.0% at baseline to 76.7%, of which only a higher prevalence of fragmented QRS (fQRS) was observed (33.3% to 50.0%, p = .013; mainly in inferior leads). ECG parameters of QT dispersion (QTd) were prolonged significantly after the regimen (39.50 ± 11.37 to 44.20 ± 15.85 ms, p = .019). Conclusion In bladder cancer patients receiving preoperative chemotherapy combined with immunotherapy, the main ECG abnormality was fQRS and QTd, with relatively normal cardiac biomarkers and echocardiographic parameters. Regular ECG screening should be carried out carefully to detect potential cardiotoxicity in the long‐term follow‐up. |
| first_indexed | 2024-03-08T09:35:40Z |
| format | Article |
| id | doaj.art-440bff25f9de45ef8e9aaf99ef4bbe1e |
| institution | Directory Open Access Journal |
| issn | 1082-720X 1542-474X |
| language | English |
| last_indexed | 2024-03-08T09:35:40Z |
| publishDate | 2024-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Annals of Noninvasive Electrocardiology |
| spelling | doaj.art-440bff25f9de45ef8e9aaf99ef4bbe1e2024-01-30T08:36:48ZengWileyAnnals of Noninvasive Electrocardiology1082-720X1542-474X2024-01-01291n/an/a10.1111/anec.13107Electrocardiographic characteristics of bladder cancer patients receiving preoperative chemotherapy combined with immunotherapyZi‐Liang Chen0Kai‐Peng Jia1Yi Zheng2Nan Zhang3Xin Wang4Gary Tse5Zhi‐Wei Zhang6Hai‐Long Hu7Tong Liu8Tianjin Key Laboratory of Ionic‐Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology The Second Hospital of Tianjin Medical University Tianjin ChinaDepartment of Urology, The Second Hospital of Tianjin Medical University Tianjin Institute of Urology Tianjin ChinaTianjin Key Laboratory of Ionic‐Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology The Second Hospital of Tianjin Medical University Tianjin ChinaTianjin Key Laboratory of Ionic‐Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology The Second Hospital of Tianjin Medical University Tianjin ChinaTianjin Key Laboratory of Ionic‐Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology The Second Hospital of Tianjin Medical University Tianjin ChinaTianjin Key Laboratory of Ionic‐Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology The Second Hospital of Tianjin Medical University Tianjin ChinaTianjin Key Laboratory of Ionic‐Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology The Second Hospital of Tianjin Medical University Tianjin ChinaDepartment of Urology, The Second Hospital of Tianjin Medical University Tianjin Institute of Urology Tianjin ChinaTianjin Key Laboratory of Ionic‐Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology The Second Hospital of Tianjin Medical University Tianjin ChinaAbstract Objective Patients treated with preoperative chemotherapy and immunotherapy for bladder cancer may be at increased risk of cardiotoxicity and electrophysiological abnormalities. This study aimed to analyze their electrocardiographic (ECG) alterations. Methods Patients with bladder cancer who were hospitalized and receiving tislelizumab plus nab‐paclitaxel (TnP) were enrolled prospectively. ECG, cardiac biomarkers, and echocardiography were performed at baseline and the end of TnP. Results A total of 60 patients (76.7% males), including 30 muscle‐invasive and 30 non‐muscle‐invasive bladder cancer, received three or four cycles of TnP, respectively. Hypertension was the commonest comorbidity (41.7%), and 25 patients (41.7%) were prescribed cardiovascular drugs. In comparison with baseline characteristics, cardiac troponin I (cTnI) and N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) were within normal ranges after TnP. However, echocardiographic parameter of left ventricular ejection fraction slightly decreased after TnP (62.81 ± 3.81% to 61.10 ± 4.37%, p = .011). The incidence of abnormal ECG increased from 65.0% at baseline to 76.7%, of which only a higher prevalence of fragmented QRS (fQRS) was observed (33.3% to 50.0%, p = .013; mainly in inferior leads). ECG parameters of QT dispersion (QTd) were prolonged significantly after the regimen (39.50 ± 11.37 to 44.20 ± 15.85 ms, p = .019). Conclusion In bladder cancer patients receiving preoperative chemotherapy combined with immunotherapy, the main ECG abnormality was fQRS and QTd, with relatively normal cardiac biomarkers and echocardiographic parameters. Regular ECG screening should be carried out carefully to detect potential cardiotoxicity in the long‐term follow‐up.https://doi.org/10.1111/anec.13107bladder cancercardio‐oncologyelectrocardiographyimmunotherapypreoperative therapy |
| spellingShingle | Zi‐Liang Chen Kai‐Peng Jia Yi Zheng Nan Zhang Xin Wang Gary Tse Zhi‐Wei Zhang Hai‐Long Hu Tong Liu Electrocardiographic characteristics of bladder cancer patients receiving preoperative chemotherapy combined with immunotherapy Annals of Noninvasive Electrocardiology bladder cancer cardio‐oncology electrocardiography immunotherapy preoperative therapy |
| title | Electrocardiographic characteristics of bladder cancer patients receiving preoperative chemotherapy combined with immunotherapy |
| title_full | Electrocardiographic characteristics of bladder cancer patients receiving preoperative chemotherapy combined with immunotherapy |
| title_fullStr | Electrocardiographic characteristics of bladder cancer patients receiving preoperative chemotherapy combined with immunotherapy |
| title_full_unstemmed | Electrocardiographic characteristics of bladder cancer patients receiving preoperative chemotherapy combined with immunotherapy |
| title_short | Electrocardiographic characteristics of bladder cancer patients receiving preoperative chemotherapy combined with immunotherapy |
| title_sort | electrocardiographic characteristics of bladder cancer patients receiving preoperative chemotherapy combined with immunotherapy |
| topic | bladder cancer cardio‐oncology electrocardiography immunotherapy preoperative therapy |
| url | https://doi.org/10.1111/anec.13107 |
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