Right ventricular echocardiographic function in patients with breast cancer undergoing anthracycline-based chemotherapy: A prospective study.

BACKGROUND

Chemotherapy regimens with anthracyclines, widely used in treating breast cancer and lymphoma, are associated with significant cardiac toxicity. While previous studies have primarily focused on left ventricular (LV) function, limited research exists on right ventricular (RV) function. This study aimed to evaluate RV echocardiographic function in breast cancer patients undergoing anthracycline-based chemotherapy.

METHODS

A cohort of 72 breast cancer patients receiving anthracycline treatment at Ghazi Tabatabai and Madani Hospitals from April to March 2022 participated in this study. Echocardiography was performed before treatment initiation, 15 days after the second chemotherapy session, and 15 days after the final session. Cardiotoxicity levels were calculated using SPSS V22 software with inferential statistical methods, including repeated measures analysis and the Friedman test.

RESULTS

RV-free wall strain remained stable 15 days after the second treatment session compared to baseline but showed a statistically significant decrease 15 days after the final session (P = 0.044). The prevalence of abnormal RV-free wall strain increased significantly during the final assessment (P = 0.037). Tumor regression grade (TRG) also demonstrated significant changes over time (P = 0.003). Right ventricular systolic pressure (RVSP) increased significantly throughout the study (P = 0.035), while no significant changes were observed in other parameters such as LVEF, E/E', LAVI, or TAPSE.

CONCLUSION

Anthracycline-based chemotherapy leads to a decline in RV-free wall strain over time, highlighting the importance of monitoring RV function alongside LV function during treatment. Advanced echocardiographic techniques, including strain imaging, may help detect subclinical RV dysfunction earlier.