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RESEARCH PRODUCT

Chemotherapy cardiotoxicity: cardioprotective drugs and early identification of cardiac dysfunction.

Daniela Di LisiGiuseppe VitaleSalvatore NovoSalvatore ArrottiR IaconaDomenico NobileNovo GiuseppinaGiuseppe LeggioAntonio RussoRiccardo M. InciardiFrancesca Bonura

subject

Cardiac function curveAdultmedicine.medical_specialtyCardiotonic Agentsmedicine.medical_treatmentAngiotensin-Converting Enzyme InhibitorsBreast Neoplasms030204 cardiovascular system & hematologyBioinformaticsCardiac dysfunctionAngiotensin-converting enzyme inhibitor; Cardiotoxicity; Chemotherapy; Prevention; Tissue Doppler imaging; Adult; Aged; Aged 80 and over; Angiotensin-Converting Enzyme Inhibitors; Antineoplastic Combined Chemotherapy Protocols; Breast Neoplasms; Cardiotonic Agents; Cardiotoxicity; Early Diagnosis; Echocardiography Doppler; Female; Follow-Up Studies; Humans; Middle Aged; Prospective Studies03 medical and health sciencesTissue Doppler imaging0302 clinical medicinecardiac toxicity anti cancer drugs cardiac dysfunctionInternal medicineAntineoplastic Combined Chemotherapy Protocols80 and overMedicineChemotherapyHumansProspective StudiesAgedAged 80 and overCardiotoxicityChemotherapybusiness.industryPreventionFollow up studiesDopplerGeneral MedicineMiddle AgedCardiotoxicityEchocardiography DopplerClinical trialEarly DiagnosisAngiotensin-converting enzyme inhibitorEchocardiography030220 oncology & carcinogenesiscardiovascular systemCardiologyFemaleCardiology and Cardiovascular MedicinebusinessFollow-Up Studies

description

Background: Chemotherapy cardiotoxicity is an emerging problem and it is very important to prevent cardiac dysfunction caused by anticancer drugs. The aim of this study was to assess the alterations of the cardiac function induced by chemotherapy in a follow-up of 2 years and to evaluate the cardioprotective role of angiotensin-converting enzyme inhibitors (ACEIs) in the prevention of cardiac dysfunction. Methods: A prospective study was carried out using patients with breast cancer (85 women; median age 57W12years) and other inclusion and exclusion criteria. On the basis of treatment, patients were divided into six groups: fluorouracil-epirubicincyclophosphamide, FEC (group A); FEC and trastuzumab (B); trastuzumab (C); FEC and taxotere (D); FEC, paclitaxel and trastuzumab (E); and chemotherapy and cardioprotective drugs (F). Cardiological evaluation including electrocardiogram and conventional echocardiogram with tissue Doppler imaging (TDI) was carried out at T0 (before starting chemotherapy), T1 (after 6months from the start of chemotherapy) and T2 (2 years after the end of chemotherapy). Results: Significant changes in the TDI parameters of systolic and diastolic function were observed at T1 and T2 in all patients. A significant reduction of left ventricular ejection fraction (LVEF) was observed only at T2. In the patients treated with ACEI (F), these changes were less significant than in other groups and they do not have significant changes in the indices of diastolic function. Conclusion: TDI is more sensitive than conventional echocardiogram in the early diagnosis of cardiac dysfunction and ACEIs seem to have an important role in the prevention of cardiotoxicity.

yearjournalcountryeditionlanguage
2016-01-01Journal of cardiovascular medicine (Hagerstown, Md.)
10.2459/jcm.0000000000000232https://pubmed.ncbi.nlm.nih.gov/25501904