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Rezaeian N, Maddah Safaei AFSANE, Asadian SANAZ, Molanaie Kamangar TARA, Hosseini LEILA. Assessment of early cardiotoxic adverse effects of doxorubicin-containing regimens in breast cancer patients. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab090.070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public hospital(s). Main funding source(s): 1. Tehran University of Medical Sciences 2. Iran University of Medical Sciences
Assessment of early cardiotoxic adverse effects of Doxorubicin-containing regimens in breast cancer patients.
Abstract: Introduction
BC is the most prevalent cancer among women and comprises about 30% of cancers in this population group1. Numerous patients with breast cancer (BC) require cardiotoxic anthracycline-based chemotherapy.
Purpose
We intended to assess the early cardiotoxic effects of doxorubicin utilizing cardiac magnetic resonance (CMR) imaging.
Methods
Frothy-nine patients including 21 otherwise healthy females with BC at a mean age (±SD) of 47.62 ± 9.07 years and 28 normal controls at a mean age (±SD) of 45.18 ± 4.29 years were recruited. BC cases underwent both CMR and TTE at baseline and seven days after four biweekly cycles of Doxorubicin and Cyclophosphamide. Functional, volumetric, and strain parameters, including global longitudinal (GLS), circumferential (GCS), and radial strain (GRS), were analyzed. The findings compared with those of 28 controls.
Results
In post-chemotherapy CMR, four patients (19.04%) displayed evidence of drug cardiotoxicity. Ventricular ejection fraction, left ventricular end-systolic volume index, and strain values significantly changed after chemotherapy (all Ps < 0.05). One patient (4.76%) had myocardial edema in post-chemotherapy CMR, and three patients (14.28%) had evidence of myocardial fibrosis. In the follow-up time of 4 to 10 months (mean: seven months) after chemotherapy, eight patients (38.09%) complained of dyspnea on exertion and fatigue. None of the CMR parameters had any correlation with the evolution of symptoms.
Conclusion
We demonstrated a significant difference in ventricular ejection fraction and global strain values early after Doxorubicin chemotherapy. Exclusive CMR parameters can aid in the early initiation of preventive cardiac strategies.
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Affiliation(s)
- N Rezaeian
- Rajaie Cardiovascular Medical & Research Center, Tehran, Iran (Islamic Republic of)
| | | | - SANAZ Asadian
- Rajaie Cardiovascular Medical & Research Center, Tehran, Iran (Islamic Republic of)
| | | | - LEILA Hosseini
- Rajaie Cardiovascular Medical & Research Center, Tehran, Iran (Islamic Republic of)
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Hosseini L, Sadeghpour A, Maleki M, Alizadehasl A, Rezaeian N, Zadehbagheri F, Bakhshandeh H, Hosseini S. 3D right ventricular ejection fraction and longitudinal strain are independent predictors of major adverse cardiovascular events in patients with rrhythmogenic right ventricular cardiomyopathy. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Evaluation of right ventricular (RV) function is essential in the follow up of patients with arrhythmogenic right ventricular cardiomyopathy (ARVC). Role of advance echocardiography including 3D transthoracic echocardiography (3DTTE) for evaluation of 3D RV function and RV longitudinal strain in predicting prognosis in ARVC patients, has not been well investigated.
Purpose
We aimed to evaluate 3DTTE parameters in predicting major advance cardiovascular events (MACE) defined as ventricular arrhythmia, cardiac hospitalization, heart transplantation, and death in ARVC patients.
Methods
Forty-eight definite ARVC subjects based on the 2010 Task force criteria were evaluated with standard 2D transthoracic echocardiography (2DTTE) and 3DTTE. Patients with poor image quality were excluded. RV function was evaluated by 2D and 3D TTE including: fractional area change (FAC), RV global and free wall longitudinal strain (RV2DGLS and RV2DFWLS) and 3D RV ejection fraction (RV3DEF), RV global and free wall longitudinal strain (RV3DGLS, and RV3DFWLS). The patients were followed up for a median period of 12 months (6–18 months) to record MACE.
Results
Forty-eight patients with mean age =38.5±14 years; 79.2% male, and mean RV3DEF =30.33%, were included. During the mean follow up 12 months, 12 patients (25%, with mean RV3DEF = 24.8±9%) experienced MACE whereas mean RV3EF in patient without any cardiovascular events during follow up was 34.21±9%. The most common causes of hospitalization were arrhythmia, right-sided heart failure, and RV clot as the following: Ventricular arrhythmia in 7 patients (14.6%, with mean RV3DEF = 29.01±8.82%), RV clot in 2 cases (4.2%, with mean RV3DEF = 20.2%), right-sided heart failure in 3 patients (6.3%, with mean RV3DEF = 16.83±3.6%) that 2 of them (2.1%, with mean RV3DEF = 14.58±0.63) underwent heart transplantation.
Logistic regression analysis revealed RV3DTTE (p-value = 0.03, OR=0.90, CI: 0.82–0.99), RV3DGLS (p-value = 0.05, OR=1.27, CI: 0.99–1.61) and RV3DFWLS (p-value = 0.01, OR=1.29, CI: 1.05–1.59), predicted cardiac adverse events, but there were no significant association between RV2DGLS, RV2DEWLS and FAC with MACE.
Conclusion
RV3DEF, RV3DGLS, and RV3DFWLS were powerful predictors of morbidity and mortality and can be useful as a valuable method in the prediction of major cardiovascular complications in ARVC patients.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- L Hosseini
- Rajaie Cardiovascular Medical & Research Center, Tehran, Iran (Islamic Republic of)
| | - A Sadeghpour
- Rajaie Cardiovascular Medical & Research Center, Tehran, Iran (Islamic Republic of)
| | - M Maleki
- Rajaie Cardiovascular Medical & Research Center, Tehran, Iran (Islamic Republic of)
| | - A Alizadehasl
- Rajaie Cardiovascular Medical & Research Center, Tehran, Iran (Islamic Republic of)
| | - N Rezaeian
- Rajaie Cardiovascular Medical & Research Center, Tehran, Iran (Islamic Republic of)
| | - F Zadehbagheri
- Rajaie Cardiovascular Medical & Research Center, Tehran, Iran (Islamic Republic of)
| | - H Bakhshandeh
- Rajaie Cardiovascular Medical & Research Center, Tehran, Iran (Islamic Republic of)
| | - S Hosseini
- Rajaie Cardiovascular Medical & Research Center, Tehran, Iran (Islamic Republic of)
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Soori R, Rezaeian N, Khosravi N, Ahmadizad S, Taleghani H, Jourkesh M, Stannard S. Effects of water-based endurance training, resistance training, and combined water and resistance training programs on visfatin and ICAM-1 levels in sedentary obese women. Sci Sports 2017. [DOI: 10.1016/j.scispo.2016.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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