Author + information
- Mehmet Hayri Alıcı1,
- Ozan Balakan2,
- Suleyman Ercan3,
- Musa Cakici4,
- Fethi Yavuz5 and
- Vedat Davutoglu3
Breast cancer is the most common type of cancer in women. Treatment of breast cancer includes surgery, chemotherapy and radiotherapy. These treatment modalities have beneficial effect on prognosis with the cost of potential serious cardiac side effects. Cardiac effects are usually recognised after clinical symptom or sign occurence. However, subclinical cardiac side effects can be determined by electrocardiography or echocardiography even in the early period. In this study we aimed to determine the potential subclinical cardiotoxic effects of chemotherapy in patients with breast cancer during early period.
Fifty-one patients consecutively enrolled to the sudy. All patient were diagnosed as breast cancer at oncology hospital in University of Gaziantep. All patients were taken lower cemotherapy dosage than well known cardiac safety dosage limits. The chemotherapy type, total dose and number of cure and region of radiation therapy were determined in all patients. Before chemotherapy all of the patients underwent to detailed ECG and ECHO examinations. After 6 months detailed ECG and ECHO examinations were repeated and compared with baseline values.
Our study results are as follows: statistically significant decrease in ejection fraction was found after treatment (62.3%±3.3 versus 59.9±5.9%, p:0.002,). Significant increase in the transmitral A flow velocity and significant decrease of E / A ratio were observed on Doppler ECHO analysis (77.4±19.1 cm / sec versus 86.0±18.0 cm / sec, p<0.001; 1.01±0.3 versus 0.9±0.2, p:0.03, respectively). On tissue Doppler analysis we observed that significant reduction in the value of E’ and significantly increase E / E’ ratio were present (12.5±3.6 cm / sec versus 10.7±2.9 cm / sec, p:0.001; 6.6±2.9 versus 7.7±3.3, p:0.04, respectively). On electrocardiographic examination, heart rate was significantly increased (85±13 / min versus 85±13 / min, p:0.02), and there was prolongation of PR interval which was not reached to the statistical significance (143±16 ms versus 147±20 ms, p = 0, 09).
We evaluated the subclinical cardiac adverse effects of chemotherapy in subjects with breast cancer. We found that chemotherapy has detrimental subclinical effect on both of systolic and diastolic function in early six months period despite the prescription of lower dosage of cemothearpy than well known cardiac safety dosage limits. During post chemotherapy period, echocardiographic screening for subtle change in echocardiographic parameters should alert physician for possible cardiac toxicity of chemoradiotherapy.
|Before treatment||Sixth month of treatment||p value|