Abstract 2393: Angiotensin-Converting Enzyme Inhibitors Associated with Statins Prevent Anthracycline-Induced Alterations of the Left Ventricular Systolic Performance, with no Influence on Mitral Diastolic Filling Indices’ Deterioration
Introduction: Treatment-induced impairment of left ventricular (LV) function is a well-established consequence of anthracyclines.
Hypothesis: We assessed the hypothesis that treatment with ACE inhibitors and statins can prevent LV systolic and diastolic dysfunction in cancer patients treated with anthracycline-containing regimens.
Methods: Eighty-two patients with various malignancies, treated with epirubicin-cyclophosphamide (EC) chemotherapy concurrent with ACE inhibitor (lisinopril 10 mg/day) and statin (lovastatin 20 mg/day) (study group) and a gender- and age-matched group of 82 individuals, treated with EC chemotherapy alone (control group) were assessed by Doppler echocardiography. LV function was evaluated (at baseline and after oncologic treatment), by measuring the ejection fraction and the transmitral inflow indices: maximal velocity of the E and A waves (rapid filling and atrial filling), pressure half time (PHT) of E wave, isovolumic relaxation time (IVRT) and E wave deceleration time (DT). A telecardiology protocol for computer data transmission was employed. Analysis of data included between-group and intra-group comparison of variations in LV function at baseline and after treatment completion.
Results: No significant between-group differences at baseline were found. At the end of treatment, alterations of LV diastolic filling were documented for both groups compared to baseline: significant decrease of Emax, whereas Amax was significantly increased. Prolonged IVRT, PHT and E wave DT were also certified in both groups. The LV ejection fraction was less altered in the study group compared to the control group, proving significant difference between the 2 groups at the end-point of our study.
Conclusions: The associated treatment with ACE inhibitors and statins failed to prevent deterioration of LV diastolic function but conserved systolic performance in patients with anthracycline-containing chemotherapy