Association between clinical risk factors and left ventricular function in patients with breast cancer following chemotherapy

Autor: Hidekazu Tanaka, Keiko Sumimoto, Kumiko Dokuni, Makiko Suto, Kensuke Matsumoto, Ayu Shono, K Hirata, Shun Yokota, Hironobu Minami, Yusuke Tanaka, Kentaro Yamashita, Makiko Suzuki, Nao Shibata, Keiko Hatazawa
Rok vydání: 2020
Předmět:
Oncology
medicine.medical_specialty
Time Factors
medicine.medical_treatment
Breast Neoplasms
030204 cardiovascular system & hematology
Risk Assessment
Ventricular Function
Left
Ventricular Dysfunction
Left
03 medical and health sciences
0302 clinical medicine
Breast cancer
Predictive Value of Tests
Cancer therapeutics-related cardiac dysfunction
Trastuzumab
Internal medicine
Antineoplastic Combined Chemotherapy Protocols
medicine
Humans
Anthracyclines
Radiology
Nuclear Medicine and imaging
Aged
Retrospective Studies
Cardiotoxicity
Chemotherapy
Ejection fraction
Cumulative dose
business.industry
Cancer
Stroke Volume
Atrial fibrillation
General Medicine
Middle Aged
medicine.disease
Chemotherapy regimen
Radiation therapy
Treatment Outcome
Risk factors
Echocardiography
030220 oncology & carcinogenesis
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
medicine.drug
Zdroj: The International Journal of Cardiovascular Imaging. 37:197-205
ISSN: 1573-0743
1569-5794
Popis: Funding Acknowledgements Type of funding sources: None. Background The sequential or concurrent use of two different types of agents such as anthracyclines and trastuzumab may increase myocardial injury and cancer therapeutics-related cardiac dysfunction (CTRCD), which is often the result of the combined detrimental effect of the two therapies for breast cancer patients. For risk stratification to detect the development of CTRCD, the current position paper from the European Society of Cardiology (ESC) lists several factors associated with risk of cardiotoxicity. Purpose Our purpose was to investigate the impact of baseline risk factors on left ventricular (LV) function in patients with preserved LV ejection fraction (LVEF) who have undergone chemotherapy for breast cancer. Methods We studied 86 breast cancer patients treated with anthracyclines, trastuzumab, or both. Mean age was 59 ± 13 years and LVEF was 67 ± 5%. In accordance with the current definition, CTRCD was defined as a decline in LVEF of >10% to an absolute value of Results The relative decrease in LVEF after chemotherapy for patients with more than four risk factors was significantly greater than that for patients without (-9.3 ± 10.8% vs. -2.2 ± 10.2%; p = 0.02). However, this finding did not apply to patients with more than one, two or three risk factors. Patients with more than four risk factors also tended to show a higher prevalence of CTRCD than those without (14.3% vs. 2.8%, p = 0.12). Moreover, patients with more than four risk factors were more likely to have higher LV mass index (109.3 ± 29.0g/m² vs. 83.2 ± 21.0g/m², p Furthermore, receiver-operator characteristics curve analysis showed that an optimal cut off value of a cumulative total doxorubicin dose for developing LV dysfunction in patients with more than any of four risk factors was lower than that in those without (180 mg/m² vs. 280 mg/m²). Conclusions Association between clinical risk factors and LV dysfunction following chemotherapy became stronger with an increase in the number of risk factors in breast cancer patients, and was especially strong for patients treated with chemotherapy who had more than four risk factors. Our findings can thus be expected to have clinical implications for better management of patients with breast cancer referred for chemotherapy. Abstract Figure.
Databáze: OpenAIRE
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