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Evaluation of Right and Left Ventricular Systolic Functions in Breast Cancer Patients on Chemotherapy: A Transthoracic Echo Study

    Authors

    • Taher Owaed Shellal 1
    • Muataz Fawzi Hussein 2
    • Thamer Imad Al-Jawahiri 1
    • Wisam Abdul Abbas Alattar 1

    1 Ibn Al-Nafees Teaching Hospital, Baghdad, Iraq.

    2 College of Medicine, University of Baghdad.

,

Document Type : Research Paper

10.52573/ipmj.2024.186092
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Abstract

BACKGROUND: 
Cardio-toxicity is a major complication of chemotherapy for breast cancer women, and so evaluation of cardiac function   is important   to protect the heart from harmful drug toxic effects.
OBJECTIVE:
To assess and evaluate the cardio-toxic sequelae of chemotherapy used in the treatment of breast cancer on the left and right ventricular systolic functions by Transthoracic Echocardiography.
PATIENTS AND METHODS: 
This is a cross-sectional study that was carried out in Baghdad Teaching Hospital in Baghdad .                   A sample of 60 women with breast cancer on chemotherapy combination: Endoxan (Cyclophosphamide) + Doxorubicin and Herceptin(Trastuzumab) + Taxol (Paclitaxel) and 30 healthy women without chemotherapy were enrolled in the study Specific echocardiographic parameters for right and left ventricular functions, in addition to hemodynamic measurements, were assessed by               the transthoracic echocardiography.
RESULTS:  
There were significant differences regarding left ventricular ejection fraction, which was significantly reduced in women receiving chemotherapy (P=0.003). Left ventricular systolic myocardial velocity showed significant reduction in women receiving chemotherapy (P=0.0001). The mitral annular plane systolic excursion was significantly reduced in women receiving chemotherapy (P=0.0002). A significant decline in the fractional area change of the right ventricle among chemotherapy women receivers, P=0.005. Also, the Tricuspid annular plane systolic excursion was statistically with significant reduction (P=0.0001).
CONCLUSION:
This study demonstrated that chemotherapy for Breast cancer causes a decrease in both left ventricular and right ventricular systolic functions.
Moreover, the transthoracic echocardiographic study showed that the effect on left ventricle functions was more evident than on right ventricular functions.
 

Keywords

  • Cancer Therapeutics-Related Cardiac Function
  • LV Ejection Fraction
  • Myocardial Systolic Tissue Velocity
  • Tricuspid Annular Plane Systolic Excursion
  • Fractional area Change
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References
  1. Juan Carlos Plana et al: Expert Consensus for Multimodality Imaging Evaluation of Adult Patients during and after Cancer Therapy: A Report from the American Society of Echocardiography and the European Association of Cardiovascular Imaging, Journal of the American Society of Echocardiography 2014;27:911–39, Published in September. http://dx.doi.org/10.1016/j.echo.2014.07.012 .
  2. Rebecca Dobson: British Society for Echocardiography and British Cardio-Oncology Society guideline for transthoracic echocardiographic assessment of adult cancer patients receiving anthracyclines and/or trastuzumab, Echo Research & Practice volume 8, pages G1–G18 (2021). https://doi.org/10.1530/ERP-21-0001
  3. Lyon et al: 2022 ESC Guidelines on cardio-oncology developed in collaboration with the EHA, ESTRO, and IC-OS: Developed by the task force on cardio-oncology of the European Society of Cardiology. Eur Heart J, 2022;43,: 4229–361. https://doi.org/10.1093/eurheartj/ehac244
  4. Asteggiano R, Lancellotti P, Galderisi M, Ederhy S, Moonen M. Cardiac imaging in cardio-oncology. In: Zamorano JL, Bax JJ, Knuuti J, Lancellotti P, Pinto FJ, Popescu BA, et al., editors. The ESC Textbook of Cardiovascular Imaging. Oxford University PressOxford; 2021: 613–26.
  5. Yamashita and others: Association between clinical risk factors and left ventricular function in patients with breast cancer following chemotherapy, European Heart Journal - Cardiovascular Imaging, 2021;22,Issue Supplement_1, jeaa356.020. https://doi.org/10.1093/ehjci/020.
  6. Vahabi et al : Anthracycline chemotherapy and its effects on left ventricular mechanics : insights into the PROACT PLUS study, European Heart Journal - Cardiovascular Imaging, 2022;23,jeab289.026. https://doi.org/10.1093/ehjci/jeab289.026
  7. Concetta Zito et al: Anthracyclines and regional myocardial damage in breast cancer patients. A multicentre study from the Working Group on Drug Cardiotoxicity and Cardioprotection, Italian Society of Cardiology, European Heart Journal - Cardiovascular Imaging, 2021;22:406–15. doi:10.1093/ehjci/jeaa339.
  8. Tinoco et al: Association between cardiovascular risk factors and cancer therapy-related cardiac dysfunction in patients with breast cancer, European Heart Journal - Cardiovascular Imaging, 2022;23: jeab289.318. https://doi.org/10.1093/ehjci/jeab289.318.
  9. Rezaeian et al: Assessment of early cardiotoxic adverse effects of doxorubicin-containing regimens in breast cancer patients, European Heart Journal - Cardiovascular Imaging, 2021;22, jeab090.070. https://doi.org/10.1093/ehjci/jeab090.070
  10. Cardoso Torres et al: Cardiac dysfunction in breast cancer patients treated with anthracyclines: a single-center experience, European Heart Journal - Cardiovascular Imaging, 2020;21,, jez319.336. https://doi.org/10.1093/ehjci/jez319.336
  11. Feigenbaum, Armstrong et al : Evaluation of Systolic and Diastolic Function of the left ventricle ,Fegenbaum , Feigenbaum’s Echocardiography, 8TH Edition 2019 :2579-841.
  12. Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, et al. Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Journal of the American Society of Echocardiography. 2015;28:1-39.e14 doi:1016/j.echo.2014.10.003
  13. Liviu Cirin et al . Mitral Annular Plane Systolic Excursion (MAPSE) : A Review of a Simple and Forgotten Parameter of Assessing Left Ventricle Function.Journal of Clinical Medicine. 2024;13:5265. doi: 3390/jcm13175265
  14. Thomas H Marwick et al: Global Left Ventricular Systolic: Ejection fraction versus strain, Roberto M et al, Ase’s Comprehensive Echocardiography,3rd edition, Philadelphia, 2022; Section VI, Chapter 24: 146.
  15. Ali Saad, Al-shammari et al. (2020) ‘2020 ase 31st annual scientific sessions’, Journal of the American Society of Echocardiography, 33(6). doi: 10.1016/j.echo.2020.04.015.
  16. Fujiwara J et al: Longitudinal change of regional left ventricular deformation by 2D speckle tracking for chemotherapy-induced cardiotoxicity in patients with breast cancer: European Heart Journal - Cardiovascular Imaging, 2020; 21, Issue Supplement_1, jez319.1132. Page 1776.A https://doi.org/10.1093/ehjci/jez319.1132.
  17. Sumin A et al : Right ventricular diastolic dysfunction in breast cancer patients undergoing chemotherapy, European Heart Journal - Cardiovascular Imaging, 2022;23, Issue Supplement_1, . https://doi.org/10.1093/ehjci/jeab289.303
  18. Justin C wu et al: Right Ventricular Structure and Function, Libby et al, Braunwald E. Heart Disease: A Textbook of Cardiovascular Medicine, 12th ed. Philadelphia, Pa: Elsevier Saunders; 2022; Chapter 16: 209.
  19. Zaidi, A., Knight, D.S., Augustine, D.X. et al.Echocardiographic Assessment of the Right Heart in Adults: A Practical Guideline from the British Society of Echocardiography.  Echo Research & Practice2020; 7:G28. https://doi.org/10.1530/ERP-19-0051
  20. Sadi Benett et al: The role of the Tei index in assessing for cardiotoxicity from anthracycline chemotherapy: a systematic review, Echo Research & Practice 2021;8s:R1–R11. doi: 1530/ERP-20-0013
  21. L Ferri et al: Right ventricular involvement in breast cancer patients undergoing chemotherapy, European Heart Journal - Cardiovascular Imaging, 2022;23,Issue Supplement_1, jeab289.079. https://doi.org/10.1093/ehjci/jeab289.079
  22. S Vahabi et al: Right ventricular mechanics in anthracycline chemotherapy: insights into the PROACT PLUS study, European Heart Journal - Cardiovascular Imaging, 2022;23, jeab289.418.
  23. Alenezi, Fawaz, et al. “Hemodynamics of the right ventricle and the pulmonary circulation.” Applications in Engineering Science,2022;10:100102, https://doi.org/10.1016/j.apples.2022.100102.
  24. Pereira, A, et al. “Haemodynamic assessment of right ventricular overload in pulmonary hypertension: Old parameters still fit better than new ones.” European Heart Journal, 2020;41,Supplement_2, https://doi.org/10.1093/ehjci/ehaa946.2302.
  25. Boczar KE, Aseyev O, Sulpher J: Right heart function deteriorates in breast cancer patients undergoing anthracycline-based chemotherapy. Echo Res Pract. 2016;3:79–84. doi:1530/ERP-16-0020
  26. Nowsheen S et al. Trastuzumab in female breast cancer patients with reduced left ventricular ejection fraction. Journal of the American Heart Association. 2018;7:e008637. DOI:1161/JAHA.118.008637
  27. Gulati G Et al. Cancer and cardiovascular disease: the use of novel echocardiography measures to predict subsequent cardiotoxicity in breast cancer treated with anthracyclines and trastuzumab. Curr Heart Fail Rep 2014;11:366–73. DOI:1007/s11897-014-0214-8.
  28. Cao L Et al. Diastolic Dysfunction Occurs Early in HER2-Positive Breast Cancer Patients Treated Concurrently with Radiation Therapy and Trastuzumab. Oncologist 2015;20:605–14. DOI: 1634/theoncologist.2014-0299
  29. Chen J Et al. Incidence of heart failure or cardiomyopathy after adjuvant trastuzumab therapy for breast cancer, Journal of the American College of Cardiology 2012;60:2504–12. DOI:1016/j.jacc.2012.07.068
  30. Tanindi A et al. Assessment of right ventricular functions during cancer chemotherapy. Eur J Echocardiography 2011;12:834–40. DOI:1093/ejechocard/jer142
  31. Tadic M. Multimodality evaluation of the right ventricle: an updated review. Clin Cardiol 2015; 38:770–76. DOI:1002/clc.22443
  32. Yoon HJ et al. Chemotherapy-Induced Left Ventricular Dysfunction in Patients with Breast Cancer. J Breast Cancer 2016; 19:402–9. doi:4048/jbc.2016.19.4.402
  33. Reuvekamp EJ et al. Does diastolic dysfunction precede systolic dysfunction in trastuzumab-induced cardiotoxicity? Assessment with multigated radionuclide angiography (MUGA). J Nucl Cardiol 2016; 23: 824–32. doe: 10.1007/s12350-015-0164-x.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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    • PDF Download: 61
Iraqi Postgraduate Medical Journal
Volume 23, Issue 4
October 2024
Page 456-465
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APA

Shellal, T., Hussein, M., Al-Jawahiri, T., & Alattar, W. (2024). Evaluation of Right and Left Ventricular Systolic Functions in Breast Cancer Patients on Chemotherapy: A Transthoracic Echo Study. Iraqi Postgraduate Medical Journal, 23(4), 456-465. doi: 10.52573/ipmj.2024.186092

MLA

Taher Owaed Shellal; Muataz Fawzi Hussein; Thamer Imad Al-Jawahiri; Wisam Abdul Abbas Alattar. "Evaluation of Right and Left Ventricular Systolic Functions in Breast Cancer Patients on Chemotherapy: A Transthoracic Echo Study". Iraqi Postgraduate Medical Journal, 23, 4, 2024, 456-465. doi: 10.52573/ipmj.2024.186092

HARVARD

Shellal, T., Hussein, M., Al-Jawahiri, T., Alattar, W. (2024). 'Evaluation of Right and Left Ventricular Systolic Functions in Breast Cancer Patients on Chemotherapy: A Transthoracic Echo Study', Iraqi Postgraduate Medical Journal, 23(4), pp. 456-465. doi: 10.52573/ipmj.2024.186092

VANCOUVER

Shellal, T., Hussein, M., Al-Jawahiri, T., Alattar, W. Evaluation of Right and Left Ventricular Systolic Functions in Breast Cancer Patients on Chemotherapy: A Transthoracic Echo Study. Iraqi Postgraduate Medical Journal, 2024; 23(4): 456-465. doi: 10.52573/ipmj.2024.186092

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