Nabati Maryam, Janbabai Ghasem, Najjarpor Mohammadreza, Yazdani Jamshid
Department of Cardiology, Faculty of Medicine, Mazandaran University of Medical Sciences, Cardiovascular Research Center, Sari, Iran.
Department of Hematology, Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
Caspian J Intern Med. 2022 Summer;13(3):511-518. doi: 10.22088/cjim.13.3.511.
Cardiovascular disease is the main cause of death among breast cancer survivors. Several chemotherapy drugs may cause cardiovascular toxicity. Our study aimed to assess the late effects of chemotherapy on left ventricular (LV) systolic and diastolic function in a group of female breast cancer survivors.
Our study was a case-control study consisted of 60 breast cancer survivors who had undergone chemotherapy for more than 5 years and a control group of 49 women without breast cancer. All patients underwent echocardiography and left ventricular ejection fraction (LVEF), global longitudinal strain (GLS), pulse-Doppler early transmitral peak flow velocity (E wave), early diastolic (e'), and left atrial (LA) diameter were calculated.
The mean LVEF and GLS were reduced in chemotherapy group (51.63±7.93% vs. 55.37±3.50%, P=0.002 and -17.99±3.27% vs. -19.25±2.27%, P=0.025). Also, the chemotherapy group had a larger left ventricular end-systolic internal diameter than the control group (1.74±0.44cm/m vs. 1.58±0.22cm/m, P= 0.011). Logistic regression analysis showed among the different cardiovascular risk factors, chemotherapy had an association with decreasing LVEF.
Breast cancer survivors might have an excess risk of having subclinical LV dysfunction over time. These findings present the potential benefits of echocardiographic assessment in breast cancer survivors.
心血管疾病是乳腺癌幸存者的主要死因。几种化疗药物可能会导致心血管毒性。我们的研究旨在评估化疗对一组女性乳腺癌幸存者左心室（LV）收缩和舒张功能的晚期影响。
我们的研究是一项病例对照研究，由60名接受化疗超过5年的乳腺癌幸存者和49名无乳腺癌的女性对照组组成。所有患者均接受超声心动图检查，并计算左心室射血分数（LVEF）、整体纵向应变（GLS）、脉冲多普勒早期二尖瓣血流峰值流速（E波）、舒张早期（e'）和左心房（LA）直径。
化疗组的平均LVEF和GLS降低（51.63±7.93%对55.37±3.50%，P = 0.002；-17.99±3.27%对-19.25±2.27%，P = 0.025）。此外，化疗组的左心室收缩末期内径大于对照组（1.74±0.44cm/m对1.58±0.22cm/m，P = 0.011）。逻辑回归分析显示，在不同的心血管危险因素中，化疗与LVEF降低有关。
随着时间的推移，乳腺癌幸存者可能有亚临床左心室功能障碍的额外风险。这些发现表明了超声心动图评估在乳腺癌幸存者中的潜在益处。
