Left Ventricular Diastolic Function Following Anthracycline-Based Chemotherapy in Patients with Breast Cancer without Previous Cardiac Disease-A Meta-Analysis.
J Clin Med
; 10(17)2021 Aug 29.
Article
em En
| MEDLINE
| ID: mdl-34501337
ABSTRACT
BACKGROUND:
Anthracycline-based chemotherapy (ANT) remains among the most effective therapies for breast cancer. Cardiotoxicity from ANT represents a severe adverse event and may predominantly manifest as heart failure. While it is well-recognised that left ventricular systolic heart failure assessment is key in ANT-treated patients, less is known about the relevance of LV diastolic functional impairment and its characterisation.METHODS:
Studies reporting on echocardiographic diastolic function parameters before and after ANT in breast cancer patients without cardiac disease were included. We evaluated pulsed wave (E/A ratio and mitral E-wave deceleration time (EDT)) and tissue Doppler (mean velocities of the mitral ring in the early diastole (e') and E/e' ratio) echocardiographic parameters.RESULTS:
A total of 892 patients from 13 studies were included. E/A ratio was significantly reduced at the end of ANT while EDT was not influenced by ANT. Additionally, e' and E/e' ratio showed no significant change after ANT. A modest reduction in LV ejection fraction and global longitudinal strain was observed at the end of ANT therapy.CONCLUSIONS:
ANT had a modest early impact on E/A ratio, without changing EDT, e', or E/e' in patients with breast cancer without cardiac disease. Randomised studies on larger populations, using new parameters are required to define the role of diastolic dysfunction in the early diagnosis of ANT-induced cardiotoxicity.
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Base de dados:
MEDLINE
Tipo de estudo:
Clinical_trials
/
Screening_studies
/
Systematic_reviews
Idioma:
En
Revista:
J Clin Med
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Alemanha