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Cardiotoxicity in Breast Cancer Treatment: What About Left Ventricular Diastolic Function and Left Atrial Function?

2019Journal article Open access
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dc.contributor.authorTimóteo, AT
dc.contributor.authorBranco, LM
dc.contributor.authorFilipe, F
dc.contributor.authorGalrinho, A
dc.contributor.authorRio, P
dc.contributor.authorPortugal, G
dc.contributor.authorOliveira, S
dc.contributor.authorCruz Ferreira, R
dc.date.accessioned2021-02-05T15:48:54Z
dc.date.available2021-02-05T15:48:54Z
dc.date.issued2019
dc.description.abstractAims: Cardiotoxicity is a possible complication of cancer treatment, particularly with anthracyclines and anti-HER2 drugs. Systolic dysfunction has already been described. Diastolic dysfunction and left atrial function are less studied. We sought to analyze the impact of cardiotoxic treatments on left ventricular diastolic function and left atrial (LA) function. Methods and results: Retrospective study of 100 patients (all women, with a mean age of 54 ± 12 years) with three exams in the span of 1 year during treatment for breast cancer. Patients with previous cancer treatment, coronary artery disease, significant valvular disease, and atrial arrhythmias were excluded. Diastolic dysfunction was classified according to international guidelines and left atrial strain was analyzed by two-dimensional speckle tracking. In our sample, 74% received anthracyclines, 83% anti-HER2, and 76% radiation treatment. In the follow-up, 20% developed new or worsening diastolic dysfunction. Age was the only independent predictor (OR 1.93, 95% CI 1.04-3.58, P = .037). In left atrial function, only the contractile function was significantly reduced in 20.8% of the patients and age was also the only independent predictor, but with a protective effect (OR 0.51, 95% CI 0.28-0.91, P = .023). Conclusions: During breast cancer treatment, 20% of the patients develop new or worsening diastolic dysfunction, being age the main determinant, suggesting higher impact of chemotherapy in older patients. Contractile left atrial function is also compromised but, in this case, age seems to be protective. Our results support a stricter surveillance in older patients together to eventually adjust chemotherapy regimens.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationEchocardiography. 2019 Oct;36(10):1806-1813.pt_PT
dc.identifier.doi10.1111/echo.14487pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3560
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherWileypt_PT
dc.subjectAdultpt_PT
dc.subjectAge Factorspt_PT
dc.subjectAgedpt_PT
dc.subjectAged, 80 and overpt_PT
dc.subjectAntibiotics, Antineoplasticpt_PT
dc.subjectBreast Neoplasmspt_PT
dc.subjectCardiotoxicitypt_PT
dc.subjectDiastolept_PT
dc.subjectEchocardiographypt_PT
dc.subjectFemalept_PT
dc.subjectFollow-Up Studiespt_PT
dc.subjectHeart Atriapt_PT
dc.subjectHumanspt_PT
dc.subjectMiddle Agedpt_PT
dc.subjectRadiation Injuriespt_PT
dc.subjectRetrospective Studiespt_PT
dc.subjectVentricular Dysfunction, Leftpt_PT
dc.subjectHSM CARpt_PT
dc.subjectHSAC ONCpt_PT
dc.titleCardiotoxicity in Breast Cancer Treatment: What About Left Ventricular Diastolic Function and Left Atrial Function?pt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage1813pt_PT
oaire.citation.issue10pt_PT
oaire.citation.startPage1806pt_PT
oaire.citation.titleEchocardiography (Mount Kisco, N.Y.)pt_PT
oaire.citation.volume36pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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