TY - JOUR
T1 - Valvular Heart Disease following Anthracycline Therapy—Is It Time to Look beyond Ejection Fraction?
AU - Zahler, David
AU - Arnold, Joshua H.
AU - Bar-On, Tali
AU - Raphael, Ari
AU - Khoury, Shafik
AU - Rozenbaum, Zach
AU - Banai, Shmuel
AU - Arbel, Yaron
AU - Topilsky, Yan
AU - Laufer-Perl, Michal
N1 - Publisher Copyright:
© 2022 by the authors.
PY - 2022/8
Y1 - 2022/8
N2 - The association between anthracycline (ANT) and left ventricle (LV) dysfunction is well known; however, data regarding its direct effect on cardiac valve function is limited. We aimed to evaluate how ANT therapy affected valvular function in patients diagnosed with breast cancer. Data were prospectively collected as part of the Israel Cardio-Oncology Registry (ICOR). Patients underwent echocardiography exams at baseline (T1), during ANT therapy (T2), and after completion within 3 months (T3) and 6 months (T4). A total of 141 female patients were included, with a mean age of 51 ± 12 years. From T1 to T4, we observed a significant deterioration in LV ejection fraction (60.2 ± 1.5 to 59.2 ± 2.7%, p = 0.0004) and LV global longitudinal strain (−21.6 (−20.0–−23.0) to −20.0 (−19.1–−21.1)%, p < 0.0001)), and an increase in LV end-systolic diameter (25 (22–27) to 27 (24–30) mm, p < 0.0001). We observed a significant increase in the incidence of new mitral regurgitation (MR) development (4 to 19%, p < 0.0001), worsening with concomitant trastuzumab therapy (6% to 31%, p = 0.003), and a trend for tricuspid regurgitation development (4% to 8%, p = 0.19). ANT therapy is associated with the development of a new valvular disease, mainly MR, which may imply the need for a valvular focus in the monitoring of cancer patients.
AB - The association between anthracycline (ANT) and left ventricle (LV) dysfunction is well known; however, data regarding its direct effect on cardiac valve function is limited. We aimed to evaluate how ANT therapy affected valvular function in patients diagnosed with breast cancer. Data were prospectively collected as part of the Israel Cardio-Oncology Registry (ICOR). Patients underwent echocardiography exams at baseline (T1), during ANT therapy (T2), and after completion within 3 months (T3) and 6 months (T4). A total of 141 female patients were included, with a mean age of 51 ± 12 years. From T1 to T4, we observed a significant deterioration in LV ejection fraction (60.2 ± 1.5 to 59.2 ± 2.7%, p = 0.0004) and LV global longitudinal strain (−21.6 (−20.0–−23.0) to −20.0 (−19.1–−21.1)%, p < 0.0001)), and an increase in LV end-systolic diameter (25 (22–27) to 27 (24–30) mm, p < 0.0001). We observed a significant increase in the incidence of new mitral regurgitation (MR) development (4 to 19%, p < 0.0001), worsening with concomitant trastuzumab therapy (6% to 31%, p = 0.003), and a trend for tricuspid regurgitation development (4% to 8%, p = 0.19). ANT therapy is associated with the development of a new valvular disease, mainly MR, which may imply the need for a valvular focus in the monitoring of cancer patients.
KW - cardio-oncology
KW - cardiotoxicity
KW - echocardiography
KW - mitral regurgitation
KW - tricuspid regurgitation
KW - valve
UR - http://www.scopus.com/inward/record.url?scp=85137586396&partnerID=8YFLogxK
U2 - 10.3390/life12081275
DO - 10.3390/life12081275
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C2 - 36013454
AN - SCOPUS:85137586396
SN - 2075-1729
VL - 12
JO - Life
JF - Life
IS - 8
M1 - 1275
ER -