Cardiotoxicity in Breast Cancer Treatment: What About Left Ventricular Diastolic Function and Left Atrial Function?
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.17/3560 |
Resumo: | Aims: Cardiotoxicity is a possible complication of cancer treatment, particularly with anthracyclines and anti-HER2 drugs. Systolic dysfunction has already been described. Diastolic dysfunction and left atrial function are less studied. We sought to analyze the impact of cardiotoxic treatments on left ventricular diastolic function and left atrial (LA) function. Methods and results: Retrospective study of 100 patients (all women, with a mean age of 54 ± 12 years) with three exams in the span of 1 year during treatment for breast cancer. Patients with previous cancer treatment, coronary artery disease, significant valvular disease, and atrial arrhythmias were excluded. Diastolic dysfunction was classified according to international guidelines and left atrial strain was analyzed by two-dimensional speckle tracking. In our sample, 74% received anthracyclines, 83% anti-HER2, and 76% radiation treatment. In the follow-up, 20% developed new or worsening diastolic dysfunction. Age was the only independent predictor (OR 1.93, 95% CI 1.04-3.58, P = .037). In left atrial function, only the contractile function was significantly reduced in 20.8% of the patients and age was also the only independent predictor, but with a protective effect (OR 0.51, 95% CI 0.28-0.91, P = .023). Conclusions: During breast cancer treatment, 20% of the patients develop new or worsening diastolic dysfunction, being age the main determinant, suggesting higher impact of chemotherapy in older patients. Contractile left atrial function is also compromised but, in this case, age seems to be protective. Our results support a stricter surveillance in older patients together to eventually adjust chemotherapy regimens. |
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Cardiotoxicity in Breast Cancer Treatment: What About Left Ventricular Diastolic Function and Left Atrial Function?AdultAge FactorsAgedAged, 80 and overAntibiotics, AntineoplasticBreast NeoplasmsCardiotoxicityDiastoleEchocardiographyFemaleFollow-Up StudiesHeart AtriaHumansMiddle AgedRadiation InjuriesRetrospective StudiesVentricular Dysfunction, LeftHSM CARHSAC ONCAims: Cardiotoxicity is a possible complication of cancer treatment, particularly with anthracyclines and anti-HER2 drugs. Systolic dysfunction has already been described. Diastolic dysfunction and left atrial function are less studied. We sought to analyze the impact of cardiotoxic treatments on left ventricular diastolic function and left atrial (LA) function. Methods and results: Retrospective study of 100 patients (all women, with a mean age of 54 ± 12 years) with three exams in the span of 1 year during treatment for breast cancer. Patients with previous cancer treatment, coronary artery disease, significant valvular disease, and atrial arrhythmias were excluded. Diastolic dysfunction was classified according to international guidelines and left atrial strain was analyzed by two-dimensional speckle tracking. In our sample, 74% received anthracyclines, 83% anti-HER2, and 76% radiation treatment. In the follow-up, 20% developed new or worsening diastolic dysfunction. Age was the only independent predictor (OR 1.93, 95% CI 1.04-3.58, P = .037). In left atrial function, only the contractile function was significantly reduced in 20.8% of the patients and age was also the only independent predictor, but with a protective effect (OR 0.51, 95% CI 0.28-0.91, P = .023). Conclusions: During breast cancer treatment, 20% of the patients develop new or worsening diastolic dysfunction, being age the main determinant, suggesting higher impact of chemotherapy in older patients. Contractile left atrial function is also compromised but, in this case, age seems to be protective. Our results support a stricter surveillance in older patients together to eventually adjust chemotherapy regimens.WileyRepositório do Centro Hospitalar Universitário de Lisboa Central, EPETimóteo, ATBranco, LMFilipe, FGalrinho, ARio, PPortugal, GOliveira, SCruz Ferreira, R2021-02-05T15:48:54Z20192019-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.17/3560engEchocardiography. 2019 Oct;36(10):1806-1813.10.1111/echo.14487info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-03-10T09:43:35Zoai:repositorio.chlc.min-saude.pt:10400.17/3560Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T17:20:52.135254Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Cardiotoxicity in Breast Cancer Treatment: What About Left Ventricular Diastolic Function and Left Atrial Function? |
title |
Cardiotoxicity in Breast Cancer Treatment: What About Left Ventricular Diastolic Function and Left Atrial Function? |
spellingShingle |
Cardiotoxicity in Breast Cancer Treatment: What About Left Ventricular Diastolic Function and Left Atrial Function? Timóteo, AT Adult Age Factors Aged Aged, 80 and over Antibiotics, Antineoplastic Breast Neoplasms Cardiotoxicity Diastole Echocardiography Female Follow-Up Studies Heart Atria Humans Middle Aged Radiation Injuries Retrospective Studies Ventricular Dysfunction, Left HSM CAR HSAC ONC |
title_short |
Cardiotoxicity in Breast Cancer Treatment: What About Left Ventricular Diastolic Function and Left Atrial Function? |
title_full |
Cardiotoxicity in Breast Cancer Treatment: What About Left Ventricular Diastolic Function and Left Atrial Function? |
title_fullStr |
Cardiotoxicity in Breast Cancer Treatment: What About Left Ventricular Diastolic Function and Left Atrial Function? |
title_full_unstemmed |
Cardiotoxicity in Breast Cancer Treatment: What About Left Ventricular Diastolic Function and Left Atrial Function? |
title_sort |
Cardiotoxicity in Breast Cancer Treatment: What About Left Ventricular Diastolic Function and Left Atrial Function? |
author |
Timóteo, AT |
author_facet |
Timóteo, AT Branco, LM Filipe, F Galrinho, A Rio, P Portugal, G Oliveira, S Cruz Ferreira, R |
author_role |
author |
author2 |
Branco, LM Filipe, F Galrinho, A Rio, P Portugal, G Oliveira, S Cruz Ferreira, R |
author2_role |
author author author author author author author |
dc.contributor.none.fl_str_mv |
Repositório do Centro Hospitalar Universitário de Lisboa Central, EPE |
dc.contributor.author.fl_str_mv |
Timóteo, AT Branco, LM Filipe, F Galrinho, A Rio, P Portugal, G Oliveira, S Cruz Ferreira, R |
dc.subject.por.fl_str_mv |
Adult Age Factors Aged Aged, 80 and over Antibiotics, Antineoplastic Breast Neoplasms Cardiotoxicity Diastole Echocardiography Female Follow-Up Studies Heart Atria Humans Middle Aged Radiation Injuries Retrospective Studies Ventricular Dysfunction, Left HSM CAR HSAC ONC |
topic |
Adult Age Factors Aged Aged, 80 and over Antibiotics, Antineoplastic Breast Neoplasms Cardiotoxicity Diastole Echocardiography Female Follow-Up Studies Heart Atria Humans Middle Aged Radiation Injuries Retrospective Studies Ventricular Dysfunction, Left HSM CAR HSAC ONC |
description |
Aims: Cardiotoxicity is a possible complication of cancer treatment, particularly with anthracyclines and anti-HER2 drugs. Systolic dysfunction has already been described. Diastolic dysfunction and left atrial function are less studied. We sought to analyze the impact of cardiotoxic treatments on left ventricular diastolic function and left atrial (LA) function. Methods and results: Retrospective study of 100 patients (all women, with a mean age of 54 ± 12 years) with three exams in the span of 1 year during treatment for breast cancer. Patients with previous cancer treatment, coronary artery disease, significant valvular disease, and atrial arrhythmias were excluded. Diastolic dysfunction was classified according to international guidelines and left atrial strain was analyzed by two-dimensional speckle tracking. In our sample, 74% received anthracyclines, 83% anti-HER2, and 76% radiation treatment. In the follow-up, 20% developed new or worsening diastolic dysfunction. Age was the only independent predictor (OR 1.93, 95% CI 1.04-3.58, P = .037). In left atrial function, only the contractile function was significantly reduced in 20.8% of the patients and age was also the only independent predictor, but with a protective effect (OR 0.51, 95% CI 0.28-0.91, P = .023). Conclusions: During breast cancer treatment, 20% of the patients develop new or worsening diastolic dysfunction, being age the main determinant, suggesting higher impact of chemotherapy in older patients. Contractile left atrial function is also compromised but, in this case, age seems to be protective. Our results support a stricter surveillance in older patients together to eventually adjust chemotherapy regimens. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019 2019-01-01T00:00:00Z 2021-02-05T15:48:54Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.17/3560 |
url |
http://hdl.handle.net/10400.17/3560 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Echocardiography. 2019 Oct;36(10):1806-1813. 10.1111/echo.14487 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Wiley |
publisher.none.fl_str_mv |
Wiley |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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