Speckle-Tracking Echocardiography in Assessment of Breast Cancer Therapy-Related Subclinical Cardiac Dysfunction
Спекл-трекинг эхокардиография в оценке субклинической сердечной дисфункции, связанной с терапией рака молочной железы
Akbalaeva B.A. Shulzhenko L.V. Pershukov I.V. Raiimbek uulu N. Batyraliev T.A. Gurovich O.V. Vinogradskaia V.V. Jainakbayev N.T. Seidalin A.O. Kamaliyeva M.R.
2024Scientific Research Institute — Ochapovsky Clinical Regional Hospital no. 1
Innovative Medicine of Kuban
2024#9Issue 28 - 15 pp.
Background: Cancer therapy-related cardiac dysfunction (CTRCD) is a new term that encompasses a wide range of potential manifestations and is etiologically associated with a wide variety of cancer treatments. Detection of early subclinical cardiac dysfunction is of great clinical importance. Objective: To assess subclinical CTRCD in women with HER2-positive locally advanced or metastatic breast cancer undergoing a course of anthracyclines (doxorubicin), docetaxel, and trastuzumab. We prospectively enrolled women aged 18-75 years with an established diagnosis of HER2-positive locally advanced or metastatic breast cancer across 3 centers. Material and methods: We monitored 122 women with HER2-positive locally advanced or metastatic breast cancer undergoing a course of anthracyclines (doxorubicin), docetaxel, and trastuzumab using speckle-tracking echocardiography. Based on the treatment protocol, we formed 3 comparison blocks: block 1 (chemotherapy: doxorubicin+cyclophosphamide); block 2 (chemotherapy+targeted therapy: docetaxel+trastuzumab), and block 3 (targeted therapy: trastuzumab). Results: The rate of subclinical CTRCD detection was high and exceeded 20%-30% in all comparison blocks after the 3rd course of chemotherapy, chemotherapy+targeted therapy, and targeted therapy. The rate of subclinical CTRCD increased significantly from the 1st to the 2nd, from the 2nd to the 3rd, from the 3rd to the 4th therapy courses in each block. Comparisons between the blocks were significant only after the 4th course of chemotherapy and the 4th course of targeted therapy (Yates-corrected chi-square, P=.0394); all the other comparisons between the blocks were not significant in terms of subclinical CTRCD rate. Discussion: Given the growing number of patients with breast cancer, such frequent monitoring of the cardiac function is likely to improve the quality of cancer treatment and might have a positive impact on the overall survival of patients with breast cancer. Conclusions: Criteria for frequency of echocardiographic monitoring of cardiac dysfunction in patients with malignant tumors, especially with HER2-positive breast cancer, should be revised.
cancer therapy-related cardiac dysfunction , left ventricular global longitudinal strain , speckle-tracking echocardiography
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Osh State University, Osh, Kyrgyzstan
Medical Center “Osh-Cardio” named after Mamat Aliyev, Osh, Kyrgyzstan
Scientific Research Institute, Ochapovsky Regional Clinical Hospital No. 1, Krasnodar, Russian Federation
Kuban State Medical University, Krasnodar, Russian Federation
Bobrov District Hospital, Voronezh Region, Bobrov, Russian Federation
Kazakh-Russian Medical University, Almaty, Kazakhstan
Salymbekov University, Bishkek, Kyrgyzstan
Voronezh State Medical University named after N.N. Burdenko, Voronezh, Russian Federation
“Gorod Zdorovya” Clinic, Voronezh, Russian Federation
Osh State University
Medical Center “Osh-Cardio” named after Mamat Aliyev
Scientific Research Institute
Kuban State Medical University
Bobrov District Hospital
Kazakh-Russian Medical University
Salymbekov University
Voronezh State Medical University named after N.N. Burdenko
“Gorod Zdorovya” Clinic
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