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Right ventricular function after breast cancer chemotherapy
Session:
Posters - K. Cardiovascular Disease In Special Populations
Speaker:
Geraldo Faia Carvalho Dias
Congress:
CPC 2021
Topic:
K. Cardiovascular Disease In Special Populations
Theme:
30. Cardiovascular Disease in Special Populations
Subtheme:
30.6 Cardio-Oncology
Session Type:
Posters
FP Number:
---
Authors:
Geraldo Dias; Pedro Von Hafe; Ana Filipa Cardoso; Tamara Pereira; Mariana Tinoco; Liliana Oliveira; Ana Sofia Rolo; Ilda Faustino; Alexandra Teixeira; Olga Azevedo; Filipa Almeida; António Lourenço
Abstract
<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><span style="font-size:10.0pt"><span style="font-family:"Arial","sans-serif""><span style="color:#333333">Background: Breast cancer chemotherapy </span></span></span><span style="font-size:10.0pt"><span style="font-family:"Arial","sans-serif"">is widely associated with cardiotoxicity, particularly with anthracyclines (AC) and trastuzumab (T). Although the development of left ventricular (LV) dysfunction is well established, the impact of these agents in the right<span style="color:#333333"> ventricular (RV) function is still not clearly defined.</span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><span style="font-size:10.0pt"><span style="font-family:"Arial","sans-serif""><span style="color:#333333">Purpose: In this study, we aim to evaluate the impact of AC and T in RV function.</span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><span style="font-size:10.0pt"><span style="font-family:"Arial","sans-serif""><span style="color:#333333">Methods: We performed a retrospective study including breast cancer patients treated with these chemotherapy agents in a single center from 2017 to 2018. The pre-treatment and the smallest post-treatment value of tricuspid annular systolic velocity (S’) were analyzed. Patients with pre-treatment right ventricular longitudinal dysfunction, defined as having S’ inferior to 9.5 cm/s, were excluded.</span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><span style="font-size:10.0pt"><span style="font-family:"Arial","sans-serif""><span style="color:#333333">Results: Fifty-one (51) women were included, with mean age of 54 ± 11 years, treated with AC (25; 49.0%), with T (8; 15.7%) or both AC and T (18; 35.3%).</span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><span style="font-size:10.0pt"><span style="font-family:"Arial","sans-serif""><span style="color:#333333">During follow-up, 2 individuals (3.9%) developed RV longitudinal dysfunction,1 under treatment with both AC and T and 1 under treatment with T. Both dysfunctions were mild (S’ of 9.0 cm/s) and transient, and only the latter was associated with concomitant LV dysfunction.</span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><span style="font-size:10.0pt"><span style="font-family:"Arial","sans-serif""><span style="color:#333333">There was a significant decrease </span></span></span><span style="font-size:10.0pt"><span style="font-family:"Arial","sans-serif"">in the S’ absolute <span style="color:#333333">values during follow-up in the three groups, with the pre-treatment to post-treatment mean values of 14.2 ± 2.0 vs 13.4 ± 2.4 cm/s (p=0.046) in AC group, 14.5 ± 2.7 vs 11.5 ± 1.9 cm/s (p=0.021) in T group and 14.1 ± 2.8 vs 11.8 ± 1.5 cm/s (p<0.001) in AC + T group.</span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><span style="font-size:10.0pt"><span style="font-family:"Arial","sans-serif""><span style="color:#333333">When considering the mean variation of pre-treatment to post-treatment S’ values (ΔS’), the larger difference was observed between the group treated with T and the group treated with AC, with a mean difference of 2.1 ± 0.9 cm/s between the groups, although after ANOVA and post hoc Tukey test this difference was not statistically significant (p=0.055).</span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><span style="font-size:10.0pt"><span style="font-family:"Arial","sans-serif"">However, when comparing the 26 individuals that were exposed to T with the remaining 25 that were not exposed, a statistically significant difference was found between the ΔS’ values of these two groups (2.54±2.3 vs 0.9±2.1 cm/s, p=0.009).</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><span style="font-size:10.0pt"><span style="font-family:"Arial","sans-serif""><span style="color:#333333">Conclusion: RV dysfunction was not </span></span></span><span style="font-size:10.0pt"><span style="font-family:"Arial","sans-serif"">a frequent finding in<span style="color:#333333"> our study; this appears to </span>be in contrast to <span style="color:#333333">what is already established for LV dysfunction. Nevertheless, there was a significant decrease in S’ absolute value during follow-up in patients treated with either T, AC or both agents. The decline in S’ seems to be more pronounced in patients treated with T compared to the patients only treated with AC. However, larger studies are needed to corroborate this finding.</span></span></span></span></span></p>
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