The concurrent use of aromatase inhibitors and radiotherapy induces echocardiographic changes in patients with breast cancer.
OBJECTIVE
Adjuvant radiotherapy (RT) for left-sided breast cancer has a negative impact on cardiac health. The concurrent use of aromatase inhibitors (AIs) during RT was found to increase the anticancer efficacy of radiation in pre-clinical models. We evaluated whether the acute effects of RT on cardiac functions are augmented by the concurrent use of AIs.


METHODS
Sixty patients with early-stage left-sided breast cancer underwent a 2D echocardiography, electrocardiogram and cardiac biomarker measurements before and after adjuvant breast RT. Data were analyzed in two groups according to AI use.


RESULTS
We observed a significant (p<0.05) decrease in right ventricular systolic function during RT in tricuspid annular plane systolic excursion (TAPSE). TAPSE decreased by 3.0 mm [95% confidence interval (CI)=1.9-4.1 mm] in the AI group and 1.4 mm (95% CI=0.3-2.4 mm) in the non-AI group. In addition, left ventricular diastolic function decreased among patients using AI, as the mitral inflow E-wave decreased 5.8 cm/s (95% CI=1.8-9.7 cm/s) (p=0.006).


CONCLUSIONS
The concurrent use of AI during RT for left-sided breast cancer led to a more pronounced change on right ventricular systolic function and left ventricular diastolic functions compared to RT alone.
Department of Oncology, Tampere University Hospital, University of Tampere, Tampere, Finland School of Medicine, University of Tampere, Tampere, Finland tanja.skytta@pshp.fi tanja.skytta@fimnet.fi.
Tanja
T
Skyttä
Heart Center, Tampere University Hospital, University of Tampere, Tampere, Finland School of Medicine, University of Tampere, Tampere, Finland.
Suvi
S
Tuohinen
Heart Center, Tampere University Hospital, University of Tampere, Tampere, Finland School of Medicine, University of Tampere, Tampere, Finland.
Vesa
V
Virtanen
Heart Center, Tampere University Hospital, University of Tampere, Tampere, Finland School of Medicine, University of Tampere, Tampere, Finland.
Pekka
P
Raatikainen
Department of Oncology, Tampere University Hospital, University of Tampere, Tampere, Finland School of Medicine, University of Tampere, Tampere, Finland.
Pirkko-Liisa
PL
Kellokumpu-Lehtinen
D000368:Aged; D047072:Aromatase Inhibitors / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D059248:Chemoradiotherapy; D004452:Echocardiography; D004562:Electrocardiography; D004958:Estradiol / Q000097:blood; D047629:Estrogen Receptor beta / Q000502:physiology; D005260:Female; D006321:Heart / Q000528:radiation effects; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D016277:Ventricular Function, Left
D047072:Aromatase Inhibitors; D047629:Estrogen Receptor beta; D004958:Estradiol
Breast cancer; aromatase inhinitors; cardiotoxicity; radiotherapy