Sarcopenia and anthracycline cardiotoxicity in patients with cancer.

Autor:	Bas O; Department of Internal Medicine, Hacettepe University, Ankara, Turkey onurbasdr@gmail.com., Erdemir AG; Department of Radiology, Hacettepe University, Ankara, Turkey., Onur MR; Department of Radiology, Hacettepe University, Ankara, Turkey., Ozer N; Department of Cardiology, Hacettepe University, Ankara, Turkey., Sener YZ; Department of Cardiology, Hacettepe University, Ankara, Turkey., Aksu S; Department of Hematology, Hacettepe University, Ankara, Turkey., Barista I; Department of Medical Oncology, Hacettepe University, Ankara, Turkey., Guner G; Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey., Guven DC; Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey., Kertmen N; Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey., Aksoy S; Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey., Turker A; Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey., Dizdar O; Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey.
Jazyk:	angličtina
Zdroj:	BMJ supportive & palliative care [BMJ Support Palliat Care] 2023 Dec; Vol. 13 (4), pp. 453-461. Date of Electronic Publication: 2021 Sep 03.
DOI:	10.1136/bmjspcare-2021-003197
Abstrakt:	Background: Several studies have suggested that sarcopenia is associated with an increased treatment toxicity in patients with cancer. The aim of this study is to evaluate the relationship between sarcopenia and anthracycline-related cardiotoxicity. Methods: Patients who received anthracycline-based chemotherapy between 2014 and 2018 and had baseline abdominal CT and baseline and follow-up echocardiography after anthracycline treatment were included. European Society of Cardiology ejection fraction criteria and American Society of Echocardiography diastolic dysfunction criteria were used for definition of cardiotoxicity. Sarcopenia was defined on the basis of skeletal muscle index (SMI) and psoas muscle index (PMI) calculated on CT images at L3 and L4 vertebra levels. Results: A total of 166 patients (75 men and 91 women) were included. Sarcopenia was determined in 33 patients (19.9%) according to L3-SMI, in 17 patients (10.2%) according to L4-SMI and in 45 patients (27.1%) according to PMI. 27 patients (16.3%) developed cardiotoxicity. PMI and L3-SMI were significantly associated with an increased risk of cardiotoxicity (L3-SMI: HR=3.27, 95% CI 1.32 to 8.11, p=0.01; PMI: HR=3.71, 95% CI 1.58 to 8.73, p=0.003). Conclusions: This is the first study demonstrating a significant association between CT-diagnosed sarcopenia and anthracycline-related cardiotoxicity. Routine CT scans performed for cancer staging may help clinicians identify high-risk patients in whom closer follow-up or cardioprotective measures should be considered. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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