Detection of the Early Cardiotoxic Effects of Doxorubicin-Containing Chemotherapy Regimens in Patients with Breast Cancer through Novel Cardiac Magnetic Resonance Imaging: A Short-term Follow-up
| Autor: | Afsaneh Maddah Safaei, Sanaz Asadian, Ebrahim Esmati, Farnaz Amouzegar Hashemi, Marzieh Lashkari, Fatemeh Jafari, Tara Molanaie Kamangar, Leila Hosseini, Kasra Kolahdouzan, Nahid Rezaeian |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Cyclophosphamide Anthracycline medicine.medical_treatment 030204 cardiovascular system & hematology Asymptomatic 03 medical and health sciences Cardiopulmonary Imaging 0302 clinical medicine Breast cancer Cardiac magnetic resonance imaging Internal medicine Medicine Radiology Nuclear Medicine and imaging Original Research Chemotherapy Cardiotoxicity Ejection fraction medicine.diagnostic_test business.industry medicine.disease Doxorubicin 030220 oncology & carcinogenesis Cardiology cardiovascular system medicine.symptom business medicine.drug |
| Zdroj: | Journal of Clinical Imaging Science |
| ISSN: | 2156-7514 |
| Popis: | Objectives: Many patients with breast cancer (BC) require cardiotoxic anthracycline-based chemotherapy. We intended to assess the early cardiotoxic effects of doxorubicin utilizing cardiac magnetic resonance (CMR) imaging. Material and Methods: Forty-nine patients including 21 otherwise healthy females with BC at a mean age (±SD) of 47.62 ± 9.07 years and 28 normal controls at a mean age (±SD) of 45.18 ± 4.29 years were recruited. They underwent CMR and transthoracic echocardiography at baseline and 7 days after four biweekly cycles of doxorubicin and cyclophosphamide. Biventricular functional, volumetric, global strain, and tissue characterization findings were analyzed and compared with those of 28 controls. Results: In post-chemotherapy CMR, 4 patients (19.04%), three symptomatic and one asymptomatic, exhibited evidence of doxorubicin cardiotoxicity. Significant differences in biventricular ejection fraction, left ventricular end-systolic volume index, and all 3D global strain values were noted after chemotherapy in comparison with the baseline (all P < 0.05). More than half of the study population showed a significant change in all right ventricular global strain values. One patient (4.76%) exhibited evidence of diffuse myocardial edema in post-chemotherapy CMR, and 3 patients (14.28%) showed myocardial fibrosis. The study participants were clinically followed up for 4–10 months (mean = 7 months). Overall, 8 patients (38.09%) complained of dyspnea on exertion and fatigue on follow-up. None of the CMR markers was associated with the development of symptoms. Conclusion: Our investigation revealed striking changes in CMR parameters in the follow-up of BC patients treated with cardiotoxic chemotherapy. These exclusive CMR features assist in the early initiation of preventive cardiac strategies. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|