title: Chemotherapy-induced cardiotoxicity: role of the tissue Doppler in the early diagnosis of left ventricular dysfunction.
abstract: Cardiotoxicity is a common complication of chemotherapy. The aim of this study was to assess the cardiotoxicity of anticancer drugs using tissue Doppler imaging. A prospective study was carried out using patients with early breast cancer (72 women, median age: 57 ± 12 year) and other inclusion and exclusion criteria. Inclusion criteria were treatment with epirubicin, trastuzumab, fluorouracil, cyclophosphamide, taxotere, and taxolo; left ventricular ejection fraction (LVEF) of more than 50%; and absence of important pathologies. Exclusion criteria were presence of known heart disease, earlier exposure to mediastinal irradiation, and earlier chemotherapy. On the basis of treatment, patients were divided into five groups: A=fluorouracil-epirubicin-cyclophosphamide (FEC), B = FEC + trastuzumab, C = trastuzumab, D = FEC + taxotere, and E = FEC + taxol + trastuzumab. Cardiological evaluation including electrocardiogram and echocardiogram was carried out at baseline, 3 months, and 6 months after the start of chemotherapy in all patients. The Doppler patterns were integrated with other echo parameters (tissue Doppler). Significant changes (P < 0.05) in the echo parameters of the tissue Doppler were observed in treated patients during follow-up but not in LVEF. In conclusion, the tissue Doppler is more sensitive than standard Doppler in the study of diastolic function and LVEF in the study of systolic function. The tissue Doppler should integrate conventional echocardiography in the study of left ventricular function in patients treated with anticancer drugs. It is very important to reduce the risk of cardiovascular complications, especially heart failure, in breast cancer survivors.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Cardiovascular and Nephro-Urological Disease, University Hospital P. Giaccone, University of Palermo, Palermo, Italy. danydilis@hotmail.it
authors.forename: Daniela
authors.initials: D
authors.lastname: Di Lisi
authors.forename: Francesca
authors.initials: F
authors.lastname: Bonura
authors.forename: Francesca
authors.initials: F
authors.lastname: Macaione
authors.forename: Angelica
authors.initials: A
authors.lastname: Peritore
authors.forename: Mariacristina
authors.initials: M
authors.lastname: Meschisi
authors.forename: Francesco
authors.initials: F
authors.lastname: Cuttitta
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Novo
authors.forename: Natale
authors.initials: N
authors.lastname: D'Alessandro
authors.forename: Salvatore
authors.initials: S
authors.lastname: Novo
mesh_terms: D018943:Anthracyclines / Q000008:administration & dosage / Q000009:adverse effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000503:physiopathology; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006321:Heart / Q000187:drug effects; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D043823:Taxoids / Q000008:administration & dosage / Q000009:adverse effects; D018487:Ventricular Dysfunction, Left / Q000139:chemically induced* / Q000175:diagnosis / Q000000981:diagnostic imaging*
chemical_list: D018943:Anthracyclines; D043823:Taxoids