Prevalence of risk factors of cardiovascular complications in elderly women with left breast cancer

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Abstract

The purpose to study the risk factors for elderly women with left breast cancer at the stage of chemotherapy and radiotherapy in the context of daily clinical practice for early detection of possible cardiovascular complications and optimization of therapy.

Material and methods. 69 women with HER2 neu negative left breast cancer without severe cardiovascular disease were examined. The first group included 39 elderly patients (67.7 ± 3.8 years). The second group consisted of 34 middle-aged patients (49.8 ± 5.7 years). In addition to the risk assessment according to the Score scale, additional factors including psychosocial factors were studied. The examination was carried out before the start of treatment, after the end of the course of doxorubicin in a cumulative dose of up to 360 mg/m2 and after the completion of radiation therapy 3D conformal radiation therapy SOD 39 Gr.

Results. In elderly patients, risk factors such as obesity, increased cholesterol, and hypertension were significantly more common. In both study groups, low physical activity was revealed associated with both cancer itself and the treatment. All examined patients had moderate reactive anxiety on the Spielberger-Hanin scale. Elderly patients showed high level of personal anxiety; the number of points scored — 49.3 ± 3.6. According to the Score scale, a moderate risk was detected in 18 (58.1%) and a high risk in 13(41.9%) elderly patients. After doxorubicin treatment asymptomatic systolic dysfunction was detected in 8 (20.5%) patients (decrease in EF<50%), 21 (75%) diastolic dysfunction with relaxation slowdown (E/A<1). In 9 (23.1%) of the women without reducing the EF fibrotic changes in the myocardium of the left ventricle was revealed. In 8 (20.5%) women a thickening of the pericardial layer was revealed.

Conclusion. The findings suggest the need for a personalized approach and assessment of risk factors in patients of different age groups with left breast cancer at the stage of preparation and conduct of chemoradiotherapy. This highlights the need for enhanced history collection and consideration of not only key but also additional risk factors. The results of the study can be used in the work of practical health care institutions for the planning, development, implementation and control of chemoradiography safety in terms of preventing cardiovascular complications.

About the authors

I. V. Vologdina

A.M. Granov Russian Research Center for Radiology and Surgical Technologies

Email: elporoshina@mail.ru
Russian Federation, 70, Leningradskaya street, Pesochny, St. Petersburg, 197758

E. G. Poroshina

North-Western State Medical University named after I.I. Mechnikov

Author for correspondence.
Email: elporoshina@mail.ru
Russian Federation, 41, Kirochnaya street, Saint-Petersburg, 191015

R. M. Zhabina

A.M. Granov Russian Research Center for Radiology and Surgical Technologies

Email: elporoshina@mail.ru
Russian Federation, 70, Leningradskaya street, Pesochny, St. Petersburg, 197758

A. A. Stanzhevsky

A.M. Granov Russian Research Center for Radiology and Surgical Technologies

Email: elporoshina@mail.ru
Russian Federation, 70, Leningradskaya street, Pesochny, St. Petersburg, 197758

References

  1. Васюк Ю.А., Несветов В.В., Школьник Е.Л., и др. Возможности современных эхокардиографических технологий в ранней диагностике кардиотоксического действия химиотерапевтических препаратов антрациклинового ряда у онкологических больных // Кардиология. – 2017. – Т. 57. – № S4. – С. 31−37. [Vasiuk YuA, Nesvetov VV, Shcolnic EL, et al. Possibilities of modern echocardiographic technologies in the early diagnosis of the cardiotoxic effect of chemotherapy drugs anthracycline series in cancer patients. Cardiology. 2017;57(S4):31-37. (In Russ.)]. https://doi.org/10.18087/cardio.2417.
  2. Вологдина И.В., Жабина Р.М., Корытова Л.И., и др. Кардиоваскулярные осложнения у онкологических больных на этапе проведения ХЛТ: современное состояние проблемы // Вопросы онкологии. – 2018. – T. 64. – № 4. – С. 470−477. [Vologdina IV, Zhabina RM, Korytova LI, et al. Cardiovascular complications in oncological patients at stage of chemoradiotherapy: actual position of the problem. Problems in oncology. 2018; 64(4):470-477. (In Russ.)]
  3. Гендлин Г.Е., Емелина Е.И., Никитин И.Г., Васюк Ю.А. Современный взгляд на кардиотоксичность химиотерапии онкологических заболеваний, включающей антрациклиновые антибиотики // Российский кардиологический журнал. – 2017. – Т. 22. – № 3. – С. 145−154. [Gendlin GE, Emelina EI, Nikitin IG, Vasiuk YuA. Modern view on cardiotoxicity of chemotherapeutics in oncology including anthracyclines. Russian journal of cardiology. 2017;22(3):145-154. (In Russ.)]. https://doi.org/10.15829/1560-4071-2017-3-145-154.
  4. Adão R, de Keulenaer G, Leite-Moreira A, Brás-Silva C. Cardiotoxicity associated with cancer therapy: pathophysiology and prevention strategies. Rev Port Cardiol. 2013;32(5):395-409. https://doi.org/10.1016/j.repc.2012. 11.002.
  5. Zamorano JL, Lancellotti P, Rodrigues Munoz D, et al. 2016 ESC position paper on cancer treatment and cardiovascular toxity developed under the auspices of the ESC committee for practice guedlines: the task force for cancer treatment and cardiovascular toxity of the europen society of cardiology (ESC). European Heart Journal. 2016;37(36):2768-2801. https://doi.org/10.1093/eurheartj/ehw211.
  6. Bovelli D, Plataniotis G, Roila F. Cardiotoxicity of chemotherapeutic agents and radiotherapy-related heart disease: ESMO clinical practice guidelines. Ann Oncol. 2010;21 Suppl 5:v277-282. https://doi.org/10.1093/annonc/mdq200.
  7. Оганов Р.Г., Симаненков В.И., Бакулин И.Г., и др. Коморбидная патология в клинической практике. Алгоритмы диагностики и лечения // Кардиоваскулярная терапия и профилактика. – 2019. – Т. 18. – № 1. − С. 5−66. [Oganov RG, Simanenkov VI, Bakulin IG, et al. Comorbidities in clinical practice. Algorithms for diagnostics and treatment. Cardiovascular therapy and prevention. 2019;18(1):5-66. (In Russ.)]. https://doi.org/15829/1728-8800-2019-1-5-66.
  8. Nocon M, Hiemann T, Müller-Riemenschneider F, et al. Association of physical activity with all-cause and cardiovascular mortality: a systematic review and meta-analysis. Eur J Cardiovasc Prev Rehabil. 2008;15(3):239-246. https://doi.org/10.1097/HJR.0b013e3282f55e09.
  9. Федорец В.Н., Вологдина И.В., Порошина Е.Г. Клиническое значение когнитивных и аффективных нарушений у больных пожилого и старческого возраста с сердечной недостаточностью // Медицина, теория и практика. – 2017. – Т. 2. – № 2. – С. 30−37. [Fedorets VN, Vologdina IV, Poroshina EG. Clinical significance of cognitive and affective disorders in elderly patients with chronic heart failure. Medicine: theory and practice. 2017;2(2):30-37. (In Russ.)]
  10. Aapro M, Bernard-Marty C, Brain EG, et al. Anthracycline cardiotoxicity in the elderly cancer patient: a SIOG expert position paper. Ann Oncol. 2011;22(2):257-267. https://doi.org/ 10.1093/annonc/mdq609.
  11. Serrano C, Cortés J, De Mattos-Arruda L, et al. Trastuzumab-related cardiotoxicity in the elderly: a role for cardiovascular risk factors. Ann Oncol. 2019;30(7):1178. https://doi.org/10.1093/annonc/mdy534.
  12. Консон К., Фролова Е.В., Костюкович О.М. Мультидисциплинарный подход в гериатрии // Вестник Северо-Западного государственного медицинского университета им. И.И. Мечникова. – 2018. – Т. 10. – № 4. – С. 49−54. [Konson K, Frolova EV, Kostyukovich OM. Multidisciplinary approach in geriatrics. Herald of north western state medical university named after I.I. Mechnikov. 2018;10(4):49-54. (In Russ.)]. https://doi.org/10.17816/mechnikov201810449-54.
  13. Curigliano G, Cardinale D, Suter T, et al. Cardiovascular toxicity induced by chemotherapy, targeted agents and radiotherapy: ESMO clinical practice guidelines. Ann Oncol. 2012;23 Suppl 7:vii155-66. https://doi.org/10.1093/annonc/mds293.
  14. Hooning MJ, Botma A, Aleman BM, et al. Long-term risk of cardiovascular disease in 10-year survivors of breast cancer. J Natl Cancer Inst. 2007;99(5):365-375. https://doi.org/10.1093/jnci/djk064.
  15. Бойцов С.А., Погосова Н.В., Бубнова М.Г., и др. Кардиоваскулярная профилактика 2017. Российские национальные рекомендации // Российский кардиологический журнал. – 2018. – Т. 23. – № 6. − С. 7−122. [Boycov SA, Pogosova NV, Bubnova MG, et al. Kardiovaskulyarnaya profilaktika 2017. Rossiyskie nacional’nye rekomendacii. Russian journal of cardiology. 2018;23(6):7-122. (In Russ.)]. https://doi.org/10.15829/1560-4071-2018-6-7-122.
  16. Banerjee A. A review of family history of cardiovascular disease: risk factor and research tool. Int J Clin Pract. 2012;66(6):536-543. https://doi.org/10.1111/j.1742-1241. 2012.02908.x.
  17. Порошина Е.Г., Вологдина И.В., Пестерева Е.В. Психологические особенности и качество жизни у онкологических больных с сочетанной сердечно-сосудистой патологией // Вестник Северо-Западного государственного медицинского университета им. И.И. Мечникова. – 2017. – Т. 9. − № 1. – С. 83−89. [Poroshina EG, Vologdina IV, Pestereva EV. Psychological characteristics and quality of life of cancer patients with concomitant cardiovascular pathology. Herald of north western state medical university named after I.I. Mechnikov. 2017;9(1):83-89. (In Russ.)]. https://doi.org/10.17816/mechnikov20179183-88.
  18. Муромцева Г.А., Концевая А.В., Константинов В.В., и др. Распространенность факторов риска неинфекционных заболеваний в российской популяции в 2012−2013 гг. Результаты исследования ЭССЕ-РФ // Кардиоваскулярная терапия и профилактика. – 2014. – Т. 13. – № 6. – С. 4−11. [Muromseva GA, Kontsevaya AV, Konstantinov VV, et al. The prevalence of non-infectious diseases risk factors in Russian population in 2012-2013 years. The results of ECVD-RF. Cardiovascular therapy and prevention. 2014;13(6):4-11. (In Russ.)]. https://doi.org/10.15829/1728-8800-2014-6-4-11.
  19. Дедов И.И., Шестакова М.В., Галстян Г.Р. Распространенность сахарного диабета 2-го типа у взрослого населения России (исследование NATION) // Сахарный диабет. – 2016. – Т. 19. – № 2. – С. 104−112. [Dedov II, Shestakova MV, Galstian GR. The prevalence of type 2 diabetes mellitus in the adult population of Russia (NATION study). Diabetes mellitus. 2016;19(2):104-112. (In Russ.)]. https://doi.org/10.14341/ DM2004116-17.
  20. Rao Kondapally Seshasai S, Kaptoge S, Thompson A, et al. Diabetes mellitus, fasting glucose, and risk of cause-specific death. N Engl J Med. 2011;364(9):829-841. https://doi.org/10.1056/NEJMoa1008862.

Copyright (c) 2019 Vologdina I.V., Poroshina E.G., Zhabina R.M., Stanzhevsky A.A.

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