Use of indicators of systolic and diastolic functions of the left ventricle in the diagnosis of early cardiotoxicity during chemotherapy with doxorubicin: An open, prospective, nonrandomized study

封面

如何引用文章

全文:

详细

BACKGROUND: The search for new markers of early cardiotoxicity (CT) may help reduce the incidence of severe complications in the cardiovascular system during chemotherapy with doxorubicin.

AIM: To determine echocardiography (EchoCG) parameters with the potential as CT markers in patients with primary breast cancer (BC) 12 months after the end of chemotherapy with doxorubicin.

MATERIAL AND METHODS: An open, prospective, nonrandomized study included 100 patients with verified BC who were treated at the Grodno University Clinic (Grodno, Belarus). Twelve months after the end of chemotherapy, 10 patients were excluded from the general group (7 women refused inclusion, the global longitudinal deformation of the myocardium could not be measured in 3 because of a poor acoustic window). All patients underwent transthoracic echocardiography with the assessment of systolic and diastolic myocardial function before and 12 months after the end of chemotherapy.

RESULTS: In 24/90 (26.6%) patients, a relative (before / after 12 months) decrease in global longitudinal myocardial deformity >12% (cardiotoxicity manifestation, CT+ subgroup) was detected. The cutoff point of the absolute decrease in global longitudinal myocardial deformation after 12 months was 18.0% (sensitivity, 87.9%; specificity, 83.7%). Significant differences were found between the absolute values of echocardiography in the CT+ and CT− (without CT manifestations) subgroups 12 months after the end of chemotherapy: the indexed final diastolic volume (FDV) was in 54 (49; 61) CT+ and 61 (53; 65) in CT− (p=0.034), the indexed final systolic volume (FSV) was 17 (15; 20) in CT+ and 20 (17; 23) in CT− (p=0.031), and the ratio of the rates of peaks of early and late filling of the left ventricle (E/A) in was 1.13 (1.10; 1.27) in CT+ and 1.29 (1.15; 1.45) in CT− (p=0.031). The specificity, sensitivity, and cutoff points for these parameters were established. The cutoff, sensitivity, and specificity were 57.7 62.1%, and 66.7% for FDV; 18.8, 60.6%, and 62.5% for FSV; and 1.18, 68.2%, and 66.7% for E/A, respectively.

CONCLUSION: The E/A, FDV, and FSV are candidate markers of CT 12 months after the end of chemotherapy with doxorubicin in patients with BC.

作者简介

Irina Karputs

Grodno State Medical University

编辑信件的主要联系方式.
Email: karputirina@gmail.com
ORCID iD: 0000-0003-0478-9419
SPIN 代码: 9036-3155

graduate student

白俄罗斯, Grodno

Victor Snezhitskiy

Grodno State Medical University

Email: vsnezh@mail.ru
ORCID iD: 0000-0002-1706-1243
SPIN 代码: 1697-0116

MD, Dr. Sci. (Med.), Corresponding member of NAS (Belarus), department professor

白俄罗斯, Grodno

Mikhail Kurbat

Grodno State Medical University

Email: vwmisha@mail.ru
ORCID iD: 0000-0002-8518-2450
SPIN 代码: 2216-7032

MD, Cand. Sci. (Med.), associate professor, laboratory head

白俄罗斯, Grodno

Volga Harustovich

Grodno State Medical University

Email: gorustovich1206@gmail.com
ORCID iD: 0009-0007-3089-8543
SPIN 代码: 7423-5368

MD, Cand. Sci. (Med.), senior lecturer

白俄罗斯, Grodno

Yulia Karpovich

Grodno State Medical University

Email: poluhovich1@gmail.com
ORCID iD: 0000-0001-8548-6414
SPIN 代码: 1248-1214

MD, Cand. Sci. (Med.), associate professor

白俄罗斯, Grodno

Alexander Rubinskij

Grodno Regional Clinical Cardiological Center

Email: kardio@mail.grodno.by

MD, junior researcher, ultrasound diagnostics doctor

白俄罗斯, Grodno

Tatiana Smirnova

Grodno University Clinic

Email: smir-tat.anat@mail.ru

MD, junior researcher, oncologist

白俄罗斯, Grodno

Andrei Babenka

Belarusian State Medical University

Email: labmdbt@gmail.com
ORCID iD: 0000-0002-5513-970X
SPIN 代码: 9715-4070

Cand. Sci. (Chem.), associate professor

白俄罗斯, Minsk

参考

  1. Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71(3):209–249. doi: 10.3322/caac.21660
  2. Balaji S, Antony AK, Tonchev H, et al. Racial Disparity in Anthracycline-induced Cardiotoxicity in Breast Cancer Patients. Biomedicines. 2023;11(8):2286. doi: 10.3390/biomedicines11082286
  3. Wang Z, Fan Z, Yang L, et al. Higher risk of cardiovascular mortality than cancer mortality among long-term cancer survivors. Front Cardiovasc Med. 2023;10:1014400. doi: 10.3389/fcvm.2023.1014400
  4. Lyon AR, López-Fernández T, Couch LS, et al. 2022 ESC Guidelines on cardio-oncology developed in collaboration with the European Hematology Association (EHA), the European Society for Therapeutic Radiology and Oncology (ESTRO) and the International Cardio-Oncology Society (IC-OS): Developed by the task force on cardio-oncology of the European Society of Cardiology (ESC). Eur. Heart J. 2022;43(41):4229–4361. doi: 10.1093/eurheartj/ehac244
  5. Plana JC, Galderisi M, Barac A, 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. J Am Soc Echocardiogr. 2014;27(9):911–939. doi: 10.1016/j.echo.2014.07.012
  6. Curigliano G, Lenihan D, Fradley M, et al. Management of cardiac disease in cancer patients throughout oncological treatment: ESMO consensus recommendations. Ann Oncol. 2020;31(2):171–190. doi: 10.1016/j.annonc.2019.10.023
  7. Vitsenya MV, Ageev FT, Gilyarov MYu, et al. Practical recommendations for the correction of cardiovascular toxicity of antitumor drug therapy. Zlokachestvennye opukholi. 2019;9(3S2):609–627. (In Russ). doi: 10.18027/2224-5057-2019-9-3s2-609-627
  8. Fashafsha ZZA, Chomakhidze PSH, Mesitskaya DF, et al. Early echocardiographic alterations in cancer patients during chemotherapy. Russian Journal of Cardiology. 2022;27(11):22–28. doi: 10.15829/1560-4071-2022-5093
  9. Sumin AN, Shcheglova AV, Slepynina YuS, et al. Assessment of left ventricular diastolic dysfunction following anthracyclinebased chemotherapy in breast cancer patients. Acta Biomedica Scientifica. 2022;7(3):121–133. doi: 10.29413/ABS.2022-7.3.13
  10. McDonagh T, Metra M. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Russian Journal of Cardiology. 2023;28(1):5168. doi: 10.15829/1560-4071-2023-5168
  11. Petrova E, Popel A, Shishko O, et al. Dyslipidemia and Atherosclerosis of Precerebral Arteries in Asymptomatic Patients with Subclinical Hypothyroidism. Cardiology in Belarus. 2023;15(3):333–343. (in Russ). doi: 10.34883/PI.2023.15.3.004
  12. NCI. Surveillance, Epidemiology, and End Results Program [Internet]. Cancer Stat Facts: Female Breast Cancer. Available from: https://seer.cancer.gov/statfacts/html/breast.html
  13. Chernyak SV, Kovsh YeV, Chernevskaya MV, et al. Preclinical cardiotoxicity in systemic treatment of resectable breast cancer. Emergency cardiology and cardiovascular risks. 2023;7(1):1828–1834. doi: 10.51922/2616-633X.2023.7.1.1828
  14. Chernyak SV, Kovsh YeV, Chernevskaya MV, et al. Prevention of early cardiotoxicity in the systemic treatment of resectable breast cancer. Cardiology in Belarus. 2023;15(2):193–203. doi: 10.34883/PI.2023.15.2.003
  15. Bews HJ, Mackic L, Jassal DS. Preventing broken hearts in women with breast cancer: a concise review on chemotherapy-mediated cardiotoxicity. Can J Physiol Pharmacol. 2023. doi: 10.1139/cjpp-2023-0358
  16. Levina VD, Poltavskaya MG, Sedov VP, et al. The role of left ventricle global longitudinal srain in prediction of chemotherapy – induced cardiotoxicity in breast cancer patients treated by low and moderate cumulative doses of anthracyclines. Medical Alphabet. 2022;(33):19–26. doi: 10.33667/2078-5631-2022-33-19-26
  17. Muckiene G, Vaitiekus D, Zaliaduonyte D, et al. Prognostic Impact of Global Longitudinal Strain and NT-proBNP on Early Development of Cardiotoxicity in Breast Cancer Patients Treated with Anthracycline-Based Chemotherapy. Medicina (Kaunas). 2023;59(5):953. doi: 10.3390/medicina59050953
  18. Kar J, Cohen MV, McQuiston SA, Malozzi CM. Can global longitudinal strain (GLS) with magnetic resonance prognosticate early cancer therapy-related cardiac dysfunction (CTRCD) in breast cancer patients, a prospective study? Magn Reson Imaging. 2023;97:68–81. doi: 10.1016/j.mri.2022.12.015
  19. Ardelean AM, Olariu IC, Isac R, et al. Correlation of speckle-tracking echocardiography with traditional biomarkers in predicting cardiotoxicity among pediatric hemato-oncology patients: a comprehensive evaluation of anthracycline dosages and treatment protocols. Children (Basel). 2023;10(9):1479. doi: 10.3390/children10091479
  20. Gunsaulus M, Alsaied T, Tersak JM, et al. Abnormal global longitudinal strain during anthracycline treatment predicts future cardiotoxicity in children. Pediatr Cardiol. 2023. doi: 10.1007/s00246-023-03275-x
  21. Alpman MS, Jarting A, Magnusson K, et al. Longitudinal strain analysis for assessment of early cardiotoxicity during anthracycline treatment in childhood sarcoma: A single center experience. Cancer Rep (Hoboken). 2023;6(9):e1852. doi: 10.1002/cnr2.1852
  22. Zhou X, Weng Y, Jiang T, et al. Influencing factors of anthracycline-induced subclinical cardiotoxicity in acute leukemia patients. BMC Cancer. 2023;23(1):976. doi: 10.1186/s12885-023-11060-5
  23. Mincu RI, Lampe LF, Mahabadi AA, et al. Left Ventricular Diastolic Function Following Anthracycline-Based Chemotherapy in Patients with Breast Cancer without Previous Cardiac Disease-A Meta-Analysis. J Clin Med. 2021; 10(17):3890. doi: 10.3390/jcm10173890
  24. Ho E, Brown A, Barrett P, et al. Subclinical anthracycline- and trastuzumab-induced cardiotoxicity in the long-term follow-up of asymptomatic breast cancer survivors: a speckle tracking echocardiographic study. Heart. 2010;96(9):701–707. doi: 10.1136/hrt.2009.173997
  25. Upshaw JN, Finkelman B, Hubbard RA, et al. Comprehensive assessment of changes in left ventricular diastolic function with contemporary breast cancer therapy. JACC Cardiovasc Imaging. 2020;13(1):198–210. doi: 10.1016/j.jcmg.2019.07.018
  26. Nabati M, Janbabai G, Najjarpor M, Yazdani J. Late consequences of chemotherapy on left ventricular function in women with breast cancer. Caspian J Intern Med. 2022;13(3):511–518. doi: 10.22088/cjim.13.3.511
  27. Caspani F, Tralongo AC, Campiotti L, et al. Prevention of anthracycline-induced cardiotoxicity: a systematic review and meta-analysis. Intern Emerg Med. 2021;16(2):477–486. doi: 10.1007/s11739-020-02508-8
  28. Boyd A, Stoodley P, Richards D, et al. Anthracyclines induce early changes in left ventricular systolic and diastolic function: A single centre study. PLoS One. 2017;12(4):e0175544. doi: 10.1371/journal.pone.0175544
  29. Radu LE, Ghiorghiu I, Oprescu A, et al. Cardiotoxicity evaluation in pediatric patients with acute lymphoblastic leukemia — results of prospective study. Med Ultrason. 2019;21(4):449–455. doi: 10.11152/mu-2012
  30. Davydkin IL, Kuzmina TP, Zolotovskaya IA, et al. Myocardial contractility dysfunction in patients with chronic lymphocytic leukemia receiving chemotherapy and their treatment with enalapril. Russian Journal of Cardiology. 2020;25(2):90–97. doi: 10.15829/1560-4071-2020-2-3480
  31. Ferhat E, Karabekir E, Gultekin K, et al. Evaluation of the relationship between anti-inflammatory cytokines and adverse cardiac remodeling after myocardial infarction. Kardiologiya. 2021;61(10):61–70. doi: 10.18087/cardio.2021.10.n1749
  32. Mabudian L, Jordan JH, Bottinor W, Hundley WG. Cardiac MRI assessment of anthracycline-induced cardiotoxicity. Front Cardiovasc Med. 2022;9:903719. doi: 10.3389/fcvm.2022.903719
  33. Karput IA, Snezhitskii VA, Kurbat MN, et al. Changes in left ventricular systolic and diastolic function after chemotherapy for breast cancer with doxorubicin. Siberian Journal of Oncology. 2023;22(6):64–73. doi: 10.21294/1814-4861-2023-22-6-64-73
  34. Díaz-Antón B, Madurga R, Zorita B, et al. Early detection of anthracycline- and trastuzumab-induced cardiotoxicity: value and optimal timing of serum biomarkers and echocardiographic parameters. ESC Heart Fail. 2022;9(2):1127–1137. doi: 10.1002/ehf2.13782
  35. Teplyakov AT, Shilov SN, Popova AA, et al. The prognostic value of the NT-proBNP biomarkers and Fas ligand in assessing the risk of cardiotoxicity of anthracycline chemotherapy. Cardiovascular Therapy and Prevention. 2019;18(1):127–133. doi: 10.15829/1728-8800-2019-1-127-133
  36. Kryukov EV, Golubtsov OY, Tyrenko VV, et al. Possibilities of preclinical diagnosis of anthracycline cardiotoxicity using the technique of "speckle-tracking echocardiography". Bulletin of the Russian Military Medical Academy. 2021;23(1):81–88. doi: 10.17816/brmma63578
  37. Bady ASO, Fedorova SS, Yakhontov DA, Pospelova TI. Cardiovascular system state changes in non-hodgkin’s lymphoma patients during chemotherapy. Siberian Scientific Medical Journal. 2020;40(2):73–79. doi: 10.15372/SSMJ20200210
  38. Chen W, Jiao Z, Li W, Han R. Two-dimensional speckle tracking echocardiography, a powerful method for the evaluation of anthracyclines induced left ventricular insufficiency. Medicine (Baltimore). 2022;101(42):e31084. doi: 10.1097/MD.0000000000031084
  39. Kamphuis JAM, Linschoten M, Cramer MJ, et al. Early- and late anthracycline-induced cardiac dysfunction: echocardiographic characterization and response to heart failure therapy. Cardiooncology. 2020;6:23. doi: 10.1186/s40959-020-00079-3

补充文件

附件文件
动作
1. JATS XML
下载
2. Fig. 1. Study scheme. Note. РМЖ — breast cancer, GLS — global longitudinal strain, ЛЖ — left ventricle, КТ+ — subgroup with cardiotoxicity, КТ- —subgroup without cardiotoxicity, p — level of significance, n — number, ФВ ЛЖ — left ventricular ejection fraction, ХТ — chemotherapy, ЭхоКГ — echocardiography, иКДО — indexed end-diastolic volume, иКСО — indexed end-systolic volume, E / A — the ratio of the speeds of the peaks of early and late filling of the left ventricle, E / e' — the ratio of the speed of the transmitral early diastolic blood flow and the early diastolic peak of the movement of the lateral part of the mitral fibrous ring, e' — the speed of the early diastolic peak of the movement of the lateral part of the mitral fibrous ring.

下载 (250KB)
索引源数据
3. Fig. 2. Dynamics of GLS, ٪ in patients in the КТ+ and КТ- subgroups. Note. GLS — global longitudinal strain, КТ+— subgroup with cardiotoxicity, КТ- — subgroup without cardiotoxicity, p — level of significance, ХТ — chemotherapy.

下载 (99KB)
索引源数据
4. Fig. 3. Results of constructing ROC curves. Absolute GLS values (٪), 12 months after the end of chemotherapy. Note. GLS — global longitudinal strain.

下载 (70KB)
索引源数据
5. Fig. 4. Dynamics of left ventricular ejection fraction of in patients in the КТ+ and КТ- subgroups. Note. GLS — global longitudinal strain, КТ+ — subgroup with cardiotoxicity, КТ- — subgroup without cardiotoxicity, p — level of significance, ФВ ЛЖ — left ventricular ejection fraction, ХТ — chemotherapy.

下载 (109KB)
索引源数据
6. Fig. 5. Dynamics of E/A in patients in the КТ+ and КТ- subgroups. Note. КТ+ — subgroup with cardiotoxicity, КТ- — subgroup without cardiotoxicity, ХТ — chemotherapy, p — level of significance, GLS — global longitudinal strain, E/A — the ratio of the speeds of the peaks of early and late filling of the left ventricle.

下载 (99KB)
索引源数据
7. Fig. 6. Dynamics of иКДО in patients in the КТ+ and КТ- subgroups. Note. КТ+ — subgroup with cardiotoxicity, КТ- — subgroup without cardiotoxicity, ХТ — chemotherapy, p — level of significance, GLS — global longitudinal strain, иКДО — indexed end-diastolic volume.

下载 (109KB)
索引源数据
8. Fig. 7. Dynamics of иКСО in patients in the КТ+ and КТ- subgroups. Note. КТ+ — subgroup with cardiotoxicity, КТ- — subgroup without cardiotoxicity, ХТ — chemotherapy, p — level of significance, GLS — global longitudinal strain, иКCО — indexed end-diastolic volume.

下载 (105KB)
索引源数据
9. Fig. 8. Results of constructing ROC curves. Absolute values of E/A, иКДО, иКСО 12 months after the end of chemotherapy. Note. иКДО — indexed end-diastolic volume, иКСО — indexed end-systolic volume, E/A — the ratio of the speeds of the peaks of early and late filling of the left ventricle.

下载 (81KB)
索引源数据

版权所有 © Eco-Vector, 2024

Creative Commons License
此作品已接受知识共享署名-非商业性使用-禁止演绎 4.0国际许可协议的许可。

##common.cookie##