Echocardiographic Evaluation of Breast Cancer Patients on Chemotherapy
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 7, Pages 822-828
AbstractBackground: Cardiovascular disease in patients with breast cancer undergoing chemotherapy is of major growing concern. The commonly used chemotherapeutic regimen have cardiotoxic effects including doxorubicin, trastuzumab and other agents .these have acute effects on cardiac function and longterm effects on cardiac remodelling and function. There have been a few studies on this regard, Hence we aimed to investigate the early effects of chemotherapy on cardiac function in addition to association of N –terminal pro-brain natriuretic peptide and echocardiagraphic indices.
Methods: This is a prospective, single-center study including 100 patients who received a breast cancer diagnosis in the Government Royapettah Hospital between July 2021 and April 2022 before beginning chemotherapy. Before beginning chemotherapy (baseline -T1), the day following the conclusion of the second cycle (T2), and the day following the conclusion of the fourth cycle (T3), 2D echocardiography was performed on all patients enrolled.
Results: It showed that the mean age of the subjects was 44.2 ± 8.80 years. Out of all the subjects, 40% had breast cancer of right side and 60% had breast cancer of left side. Thirty percent subjects had diabetes and 40% had hypertension. Maximum subjects had undergone surgery (70%). The chemotherapy regimen followed in most of the subjects was ACP- regimen in 70% subjects, followed by 20% having CMF- regimen and 10% having TCH-regimen. It was seen that out of all the variables, only TAPSE, and S’–TV have significant difference at T1, T2 and T3. In our study 20 % had LV systolic dysfunction, 20% had LV diastolic dysfunction and 30% had RV systolic dysfunction which correlate with NT pro BNP values.
Conclusion: Tissue Doppler echocardiography is currently used and is sufficient for providing chemotherapy patients with effective cardiac care in places with limited resources. Our study also enlighten that Echo should performed at T1 and T3 stage for all chemotherapy patients with focus on RV function as it is the earlier marker for cardiotoxicity. Future molecular mechanisms will facilitate the use of medications that operate on certain molecular targets to treat cardiotoxicity
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