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Myocardial Work Brings New Insights into Left Ventricular Remodelling in Cardio-Oncology Patients

2022Journal article Open access
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dc.contributor.authorVaz Ferreira, V
dc.contributor.authorMano, T
dc.contributor.authorCardoso, I
dc.contributor.authorCoutinho Cruz, M
dc.contributor.authorBranco, LM
dc.contributor.authorAlmeida-Morais, L
dc.contributor.authorTimóteo, AT
dc.contributor.authorGalrinho, A
dc.contributor.authorCastelo, A
dc.contributor.authorGarcia Brás, P
dc.contributor.authorSimão, D
dc.contributor.authorSardinha, M
dc.contributor.authorGonçalves, A
dc.contributor.authorCruz Ferreira, R
dc.date.accessioned2022-03-16T14:47:46Z
dc.date.available2022-03-16T14:47:46Z
dc.date.issued2022
dc.description.abstractSerial transthoracic echocardiographic (TTE) assessment of 2D left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS) are the gold standard screening methods for cancer therapeutics-related cardiac dysfunction (CTRCD). Non-invasive left ventricular (LV) pressure-strain loop (PSL) provides a novel method of quantifying myocardial work (MW) with potential advantages to evaluate the impact of cardiotoxic treatments on heart function. We prospectively assessed breast cancer female patients undergoing cancer therapy through serial monitoring by 2D and 3D TTE. Patients were evaluated at T0, T1 and T2 (before, 4-6 and 12-14 months after starting therapy, respectively). Through PSL analysis, MW indices were calculated. A total of 122 patients, with a mean age of 54.7 years, who received treatment with anthracyclines (77.0%) and anti-HER2 (75.4%) were included. During a mean follow-up of 14.9 ± 9.3 months, LVEF and GLS were significantly diminished, and 29.5% developed CTRCD. All MW indices were significantly reduced at T1 compared with baseline and tended to return to baseline values at T2. Global work index and global work efficiency showed a more pronounced variation in patients with CTRCD. The presence of more than one cardiovascular risk factor, obesity and baseline left atrium volume were predictors of changes in MW parameters. In conclusion, breast cancer treatment was associated with LV systolic dysfunction as assessed by MW, with its peak at 4-6 months and a partial recovery afterwards. Assessment of myocardial deformation parameters allows a more detailed characterization of cardiac remodelling and could enhance patient screening and selection for cardioprotective therapeutics.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationInt J Environ Res Public Health. 2022 Feb 28;19(5):2826.pt_PT
dc.identifier.doi10.3390/ijerph19052826.pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/4010
dc.language.isoengpt_PT
dc.publisherMDPIpt_PT
dc.subjectHSM CARpt_PT
dc.subjectHSAC ONCpt_PT
dc.subjectBreast Neoplasms* / complicationspt_PT
dc.subjectHumanspt_PT
dc.subjectFemalept_PT
dc.subjectMiddle Agedpt_PT
dc.subjectBreast Neoplasms* / drug therapy
dc.subjectHeart Diseases*
dc.subjectStroke Volume
dc.subjectVentricular Dysfunction, Left* / chemically induced
dc.subjectVentricular Dysfunction, Left* / chemically induced
dc.subjectVentricular Dysfunction, Left* / diagnostic imaging
dc.subjectVentricular Function, Left
dc.subjectVentricular Remodeling
dc.titleMyocardial Work Brings New Insights into Left Ventricular Remodelling in Cardio-Oncology Patientspt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.startPage2826pt_PT
oaire.citation.titleInternational Journal of Environmental Research and Public Healthpt_PT
oaire.citation.volume19pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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