Chemotherapy-related cardiac dysfunction: the usefulness of myocardial work indices.

Autor: Di Lisi D; Division of Cardiology, University Hospital 'Paolo Giaccone', Palermo, Italy. danydilis@hotmail.it.; Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE) 'G. D'Alessandro', University of Palermo, Palermo, Italy. danydilis@hotmail.it., Manno G; Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE) 'G. D'Alessandro', University of Palermo, Palermo, Italy., Madaudo C; Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE) 'G. D'Alessandro', University of Palermo, Palermo, Italy., Filorizzo C; Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, 90127, Palermo, Italy., Intravaia RCM; Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE) 'G. D'Alessandro', University of Palermo, Palermo, Italy., Galassi AR; Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE) 'G. D'Alessandro', University of Palermo, Palermo, Italy., Incorvaia L; Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, 90127, Palermo, Italy., Russo A; Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, 90127, Palermo, Italy., Novo G; Division of Cardiology, University Hospital 'Paolo Giaccone', Palermo, Italy.; Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE) 'G. D'Alessandro', University of Palermo, Palermo, Italy.
Jazyk: angličtina
Zdroj: The international journal of cardiovascular imaging [Int J Cardiovasc Imaging] 2023 Oct; Vol. 39 (10), pp. 1845-1853. Date of Electronic Publication: 2023 Aug 07.
DOI: 10.1007/s10554-023-02897-9
Abstrakt: Aims: The role of left ventricular global longitudinal strain (GLS) in the diagnosis of subclinical cardiac damage induced by anticancer drugs is now consolidated. Considering some strain disadvantages such as the dependence on the haemodynamic loading conditions, the aim of our study was to investigate the usefulness of non-invasive myocardial work indices (MWI) derived from pressure-strain analysis, in the early diagnosis of cardiotoxicity.
Methods and Results: We enrolled 61 consecutive patients with breast cancer undergoing adjuvant treatment with anthracycline-containing chemotherapy followed by taxane + trastuzumab. Patients underwent a cardiological evaluation with 2D echocardiography including measurement of the left ventricular ejection fraction (LVEF) and other conventional parameters of systolic and diastolic function, GLS and MWI at baseline (T0), 3 months (T1) and 6 months (T2) after starting chemotherapy. At T1 and T2, we did not find a significant reduction in LVEF but we found a significant reduction in GLS and MWI (p value < 0.05). In addition, at T2, 31% of patients developed subclinical cardiac dysfunction defined as a relative decrease ≥ 12% of GLS from baseline. Global work index (GWI), global constructive work (GCW) and global work efficiency (GWE) decreased significantly in both patients with subclinical dysfunction and in those without subclinical dysfunction (p value < 0.05). Patients with subclinical dysfunction at T2 showed lower values of GCW at T0.
Conclusion: MWI changed significantly during chemotherapy and appeared to alter precociously compared to GLS. Therefore, a multiparametric approach including left ventricular GLS and MWI measurements should be used in the evaluation of patients undergoing cardiotoxic antineoplastic treatment.
(© 2023. The Author(s), under exclusive licence to Springer Nature B.V.)
Databáze: MEDLINE
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