title: Tissue Doppler echocardiography detects subclinical left ventricular dysfunction in patients undergoing chemotherapy for colon cancer: insights from ONCOECHO multicentre study.
abstract: BACKGROUND
  Colorectal cancer (CRC) is the second most common cancer in women and the third in men in Poland. The role of chemotherapy (CTX) depends on the stage of CRC: adjuvant CTX is a standard treatment in stage III and should also be considered in stage II with risk factors.
  
  
  OBJECTIVE
  The aim of the paper was to assess the cardiovascular consequences of CTX in CRC enrolled to the ONCOECHO multicentre study (2012-2014). To identify potential cardiotoxicity, we focused on myocardial function, heart rhythm and conduction disorders, and adverse cardiovascular events.
  
  
  METHODS
  Twenty-five CRC patients (12 women, mean age 61.3 [35-76] years), all receiving six-month adjuvant CTX were included. Thirteen patients received 5-fluorouracil (5FU)-based CTX, and 12 patients received a capecitabine-based scheme. Subjects were assessed at baseline and followed-up three, six, and 12 months after the onset of treatment. In this analysis we focused on conduction abnormalities, systolic and diastolic function of the left ventricle (LV), and cardiovascular events.
  
  
  RESULTS
  In 12-month follow-up a decrease of selected tissue Doppler parameters (e.g. S'IVS, S'lat, and E'sept) was observed, and it was significant. LV structural parameters and ejection fraction (EF) remained unaffected. Changes in myocardial performance were not influenced by CTX regimen or treatment with beta-blockers or angiotensin-converting enzyme inhibitors. CTX did not affect LV structural parameters, EF, or conduction system, nor was it associated with cardiovascular events during the 12-month follow-up.
  
  
  CONCLUSIONS
  CTX in CRC patients does not affect LV structural parameters and EF. It may, however, trigger subtle changes in myocardial performance detectable by tissue Doppler echocardiography after 12 months. Moreover, it causes a transient increase of QT, which resolves after CTX cessation.
authors.forename: Edyta
authors.initials: E
authors.lastname: Płońska-Gościniak
authors.forename: Monika
authors.initials: M
authors.lastname: Różewicz
authors.forename: Jarosław
authors.initials: J
authors.lastname: Kasprzak
authors.forename: Andrzej
authors.initials: A
authors.lastname: Wojtarowicz
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Mizia-Stec
authors.forename: Tomasz
authors.initials: T
authors.lastname: Hryniewiecki
authors.forename: Piotr
authors.initials: P
authors.lastname: Pysz
authors.affiliation: Medical University of Silesia, Katowice. andrzejkulach@gmail.com.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Kułach
authors.forename: Artur
authors.initials: A
authors.lastname: Bodys
authors.forename: Violetta
authors.initials: V
authors.lastname: Sulżyc
authors.forename: Wojciech
authors.initials: W
authors.lastname: Braksator
authors.forename: Andrzej
authors.initials: A
authors.lastname: Szyszka
authors.forename: Beata
authors.initials: B
authors.lastname: Zaborska
authors.forename: Adrianna
authors.initials: A
authors.lastname: Gościńska-Szmagała
authors.forename: Maciej
authors.initials: M
authors.lastname: Siński
authors.forename: Dariusz
authors.initials: D
authors.lastname: Kosior
authors.forename: Sebastian
authors.initials: S
authors.lastname: Szmit
authors.forename: Ilona
authors.initials: I
authors.lastname: Kowalik
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Gąsior
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use / Q000633:toxicity; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D003110:Colonic Neoplasms / Q000188:drug therapy*; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018487:Ventricular Dysfunction, Left / Q000139:chemically induced / Q000000981:diagnostic imaging* / Q000188:drug therapy
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000970:Antineoplastic Agents
keywords: cardiotoxicity; chemotherapy; colon cancer; echocardiography