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Right ventricular dysfunction during chemotherapy in patients with breast cancer

https://doi.org/10.15829/1728-8800-2022-3182

Abstract

Aim. To assess the right ventricle (RV) during chemotherapy (CT) in patients with breast cancer (BC).

Material and methods. The study included 40 women aged 35-72 years with BC who underwent anthracycline chemotherapy. The main group (n=40) included women with BC, examined at the first contact, 37 of whom were reexamined after 6 months. Control group (n=25) included women without BC.

Results. In the main group, the median transverse dimension and anterior wall thickness of the RV were significantly greater than in the control group (p<0,001). Early diastolic transtricuspid flow velocity (Et) after 6 months was lower than in the control group (p=0,003). The ratio of Et to late (At) diastolic transtricuspid flow (Et/At) in BC patients significantly decreased during the follow-up period (p<0,05) when compared with the control group and baseline values. Higher values of Tei index were noted in the main group compared to the control one (p<0,05). Using logistic regression for the Tei index, the model included radiation therapy, the total anthracycline dose, and negative affectivity score as follows: F(3,17)=12,548, p<0,001, R2=0,729. For the Et/At ratio, additional radiation therapy and heart rate were significant factors as follows: F(2,16)=12,548, p=0,005, R2=0,526.

Conclusion. Against the background of CT, deterioration of RV systolic (increase in Tei index and RV volume) and diastolic (decrease in Et and Et/At ratio) function was noted.

About the Authors

A. N. Sumin
Research Institute for Complex Issues of Cardiovascular Diseases
Russian Federation

Head of the Laboratory of Comorbidity of Cardiovascular Diseases, Department of Clinical Cardiology.

Kemerovo



Yu. S. Slepynina
Research Institute for Complex Issues of Cardiovascular Diseases
Russian Federation

Ph.D, Researcher at the Laboratory of Diagnostic Radiology, Department of Clinical Cardiology.

Kemerovo



А. V. Shcheglova
Research Institute for Complex Issues of Cardiovascular Diseases
Russian Federation

Ph.D, Researcher at the Laboratory of Comorbidity of Cardiovascular Diseases, Department of Clinical Cardiology.

Kemerovo



A. V. Ivanova
Research Institute for Complex Issues of Cardiovascular Diseases
Russian Federation

Researcher at the Laboratory of Comorbidity of Cardiovascular Diseases, Department of Clinical Cardiology.

Kemerovo



O. M. Polikutina
Research Institute for Complex Issues of Cardiovascular Diseases
Russian Federation

Ph.D, Leading Researcher at the Laboratory of Diagnostic Radiology, Department of Clinical Cardiology.

Kemerovo



References

1. Zamorano JL, Lancellotti P, Rodriguez Muñoz D, et al. ESC Scientific Document Group. 2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines: The Task Force for cancer treatments and cardiovascular toxicity of the European Society of Cardiology (ESC). Eur Heart J. 2016;37(36):2768-801. doi:10.1093/eurheartj/ehw211.

2. Biersmith MA, Tong MS, Guha A, et al. Multimodality Cardiac Imaging in the Era of Emerging Cancer Therapies. J Am Heart Assoc. 2020;9(2):e013755. doi:10.1161/JAHA.119.013755.

3. Lenneman CG, Sawyer DB. Cardio-Oncology: An Update on Cardiotoxicity of Cancer-Related Treatment. Circulation Research. 2016;118:1008-20. doi:10.1161/circresaha.115.303633.

4. Cherata DA, Donoiu I, Diaconu R, et al. Longitudinal strain analysis allows the identification of subclinical deterioration of right ventricular function in patients with cancer therapy-related left ventricular dysfunction. Discoveries (Craiova). 2019;7(2):e94. doi:10.15190/d.2019.7.

5. Planek MIC, Manshad A, Hein K, et al. Prediction of doxorubicin cardiotoxicity by early detection of subclinical right ventricular dysfunction. Cardiooncology. 2020;6:10. doi:10.1186/s40959020-00066-8.

6. Zhao R, Shu F, Zhang C, et al. Early detection and prediction of Anthracycline-induced right ventricular Cardiotoxicity by 3-dimensional echocardiography. JACC: CardioOncology. 2020;2(1):13-22. doi:10.1016/j.jaccao.2020.01.007.

7. Tadic M, Cuspidi C, Bombelli M, et al. Right heart remodeling induced by arterial hypertension: Could strain assessment be helpful? J Clin Hypertens (Greenwich). 2018;20(2):400-7. doi:10.1111/jch.13186.

8. Surkova E, Muraru D, Genovese D, et al. Relative Prognostic Importance of Left and Right Ventricular Ejection Fraction in Patients With Cardiac Diseases. J Am Soc Echocardiogr. 2019;32(11):1407-15. doi:10.1016/j.echo.2019.06.009.

9. Sumin AN, Korok EV, Sergeeva TJ. Preexisting Right Ventricular Diastolic Dysfunction and Postoperative Cardiac Complications in Patients Undergoing Nonemergency Coronary Artery Bypass Surgery. J Cardiothorac Vasc Anesth. 2021;35(3):799-806. doi:10.1053/j.jvca.2020.09.100.

10. Tello K, Seeger W, Naeije R, et al. Right heart failure in pulmonary hypertension: Diagnosis and new perspectives on vascular and direct right ventricular treatment. Br J Pharmacol. 2021;178:90107. doi:10.1111/bph.14866.

11. Amsallem M, Mercier O, Kobayashi Y, et al. Forgotten No More: A Focused Update on the Right Ventricle in Cardiovascular Disease. JACC Heart Fail. 2018;6(11):891-903. doi:10.1016/j.jchf.2018.05.022.

12. Tadic M, Cuspidi C, Hering D, et al. The influence of chemotherapy on the right ventricle: did we forget something? Clin Cardiol. 2017;40(7):437-43. doi:10.1002/clc.22672.

13. Gendlin GE, Emelina ЕI, Nikitin IG, et al. Modern view on cardiotoxicity of chemotherapeutics in oncology including anthracyclines. Russian Journal of Cardiology. 2017;(3):14554. (In Russ.)

14. Ansheles AA, Sergienko IV, Prus YuA, et al. Nuclear imaging of chemotherapy-induced cardiotoxicity. Cardiovascular Therapy and Prevention. 2021;20(2):2537. (In Russ.)

15. Raykh OI, Sumin AN, Korok EV. The Influence of Personality Type D on Cardiovascular Prognosis in Patients After Coronary Artery Bypass Grafting: Data from a 5-Year-Follow-up Study. Int J Behav Med. 2022;29(1):46-56. doi:10.1007/s12529-021-09992-y.

16. Kessing D, Denollet J, Widdershoven J, Kupper N. Self-care and health-related quality of life in chronic heart failure: A longitudinal analysis. Eur J Cardiovasc Nurs. 2017;16(7):605-13. doi:10.1177/1474515117702021.

17. Kim SR, Nho JH, Nam JH. Relationships among Type-D personality, symptoms and quality of life in patients with ovarian cancer receiving chemotherapy. J Psychosom Obstet Gynaecol. 2018;39(4):289-96. doi:10.1080/0167482X.2017.1372416.

18. Kim SR, Nho JH, Kim HY, et al. Type-D personality and quality of life in patients with primary brain tumours. Eur J Cancer Care (Engl). 2021;30(2):e13371. doi:10.1111/ecc.13371.

19. Denollet J. DS14: standard assessment of negative affectivity, social inhibition, and Type D personality. Psychosom Med. 2005;67(1):89-97. doi:10.1097/01.psy.0000149256.81953.49.

20. Barthur A, Brezden-Masley C, Connelly KA, et al. Longitudinal assessment of right ventricular structure and function by cardiovascular magnetic resonance in breast cancer patients treated with trastuzumab: a prospective observational study. J Cardiovasc Magn Reson. 2017;19(1):44. doi:10.1186/s12968017-0356-4.

21. de Souza TF, Silva TQ, Antunes-Correa L, et al. Cardiac magnetic resonance assessment of right ventricular remodeling after anthracycline therapy. Sci Rep. 2021;11(1):17132. doi:10.1038/s41598-021-96630-y.

22. Miao Y, Zhang W, Zhongi Y, et al. Diastolic function of the right ventricle is impaired in experimental type 2 diabetic rat models. Turk J Med Sci. 2014;44:448-53. doi:10.3906/SAG-1212-12.

23. Murch SD, La Gerche A, Roberts TJ, et al. Abnormal right ventricular relaxation in pulmonary hypertension. Pulm Circ. 2015;5:370-5. doi:10.1086/681268.

24. Sumin AN, Korok EV, Sergeeva TY. Impaired right ventricular filling in patients with a chronic coronary syndrome. Med Ultrason. 2021;23(3). doi:10.11152/mu-2747.

25. Schneider M, Aschauer S, Mascherbauer J, et al. Echocardiographic assessment of right ventricular function: current clinical practice. Int J Cardiovasc Imaging. 2019;35(1):49-56. doi:10.1007/s10554-018-1428-8.

26. de Mol M, Visser S, Aerts J, et al. The association of depressive symptoms, personality traits, and sociodemographic factors with health-related quality of life and quality of life in patients with advanced-stage lung cancer: an observational multi-center cohort study. BMC Cancer. 2020;20(1):431. doi:10.1186/s12885020-06823-3.


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For citations:


Sumin A.N., Slepynina Yu.S., Shcheglova А.V., Ivanova A.V., Polikutina O.M. Right ventricular dysfunction during chemotherapy in patients with breast cancer. Cardiovascular Therapy and Prevention. 2022;21(5):3182. (In Russ.) https://doi.org/10.15829/1728-8800-2022-3182

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ISSN 1728-8800 (Print)
ISSN 2619-0125 (Online)