Left Ventricular Strain in Chemotherapy-Naive and Radiotherapy-Naive Patients With Cancer |
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Authors: | Marijana Tadic Martin Genger Ana Baudisch Sebastian Kelle Cesare Cuspidi Evgeny Belyavskiy Franziska Burkhardt Lucia Venneri Philipp Attanasio Burkert Pieske |
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Affiliation: | 1. Department of Cardiology, Charité-University-Medicine Berlin, Campus Virchow Klinikum (CVK), Berlin, Germany;2. Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Standort Berlin/Charité, Berlin, Germany;3. Department of Cardiology, DeutschesHerzzentrum Berlin (DHZB), Berlin, Germany;4. Clinical Research Unit, University of Milan-Bicocca and Istituto Auxologico Italiano, Meda, Italy;5. Department of Echocardiography, Royal Brompton Hospital, London, United Kingdom |
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Abstract: | BackgroundWe sought to investigate left ventricular (LV) function and mechanics in patients with cancer before they received chemotherapy or radiotherapy, as well as the relationship between cancer and reduced LV multidirectional strain in the whole study population.MethodsThe retrospective study involved 122 chemotherapy- and radiotherapy-naive patients with cancer and 45 age- and sex-matched controls with a cardiovascular risk profile similar to that of the patients with cancer. All the patients underwent echocardiographic examination before introduction of chemotherapy or radiotherapy.ResultsLV longitudinal (?19.1% ± 2.1% vs ?17.8% ± 3.5%; P = 0.022), circumferential (?22.9% ± 3.5% vs ?20.1% ± 4.1%; P < 0.001), and radial (40.5% ± 8.8% vs 35.2% ± 10.7%; P = 0.004) strain was significantly lower in the patients with cancer than in the control group. Endocardial and midmyocardial longitudinal LV strain was significantly reduced in the patients with cancer compared with the controls, whereas epicardial longitudinal strain was similar between these groups. Endocardial, midmyocardial, and epicardial circumferential strain was significantly lower in the chemotherapy- or radiotherapy-naive patients with cancer than in the controls. Cancer was associated with reduced longitudinal (odds ratio [OR], 9.0; 95% confidence interval [CI], 2.20-23.50; P < 0.001), reduced circumferential (OR, 7.1; 95% CI, 3.80-20.40; P < 0.001), and reduced radial strain (OR, 7.2; 95% CI, 3.41-25.10; P < 0.001) independent of age, sex, body mass index, diabetes, and hypertension.ConclusionsLV mechanics was impaired in the patients with cancer compared with the controls even before initiation of chemotherapy and radiotherapy. Cancer and hypertension were associated with reduced LV multidirectional strain independent of other clinical parameters. The present results indicate that cancer itself potentially induces cardiac remodelling independent of chemotherapy and radiotherapy. |
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Keywords: | Corresponding author: Dr Marijana Tadic, Department of Cardiology, Charité-University-Medicine Berlin, Campus Virchow Klinikum (CVK), AugustenburgerPlatz 1, 13353 Berlin, Germany. Tel.: +49 176 32360011 fax: +49 30 450 653 655. |
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