Abstract 16141: The Systemic Use of Bevacizumab Has a Direct Effect on Left Ventricular Function. A Prospective Echocardiography Study
Background: Bevacizumab (BV), a humanized monoclonal antibody directed against vascular endothelial growth factor, has shown promising activity in patients (pts) with cancer by inhibiting neovascularization. This prospective study evaluated the impact of inhibition of neovascularization on left ventricular (LV) function by the use of echocardiography.
Methods: In total, 147 pts under cancer treatment were prospectively included in the study. The patients were divided into two groups according to the treatment selected by the oncologists. Group 1 (n=76, age 65.21±10.49 years) received chemotherapeutic scheme with BV and group 2 (n=71, age 65.11±11.3 years) similar chemotherapeutic scheme without BV. Echocardiography was performed before initiation of treatment and at 6 and 18 months after the completion of chemotherapy. The following parameters were evaluated: Aortic Root diameter (AR), Left Atrium dimensions (LA), LV End Diastolic Diameter (EDD), Ejection Fraction (EF), Early rapid filling wave (E), late filling wave (A), E/A ratio, mitral annulus early diastolic motion (E'), Atrial contraction (A'), Systolic myocardial motion (Sa) and E/E' ratio.
Results: Two dimensional measurements and EF were similar during follow up in both groups. In group 1, regarding the systolic function of myocardium, the Sa was significantly lower at 6 months (10.93±4.64 versus 9.90±3.59 cm/s, p=0.0007), and remained significantly lower at 18 months (10.93±4.64 versus 9.03±9.56 cm/s, p=0.003). The measurements evaluating the diastolic function demonstrated that E/E' ratio was significantly increased both at 6-month (5.83±2.53 versus 7.86±3.45, p=0.0005), and at 18-month follow up (5.83±2.53 versus 7.84±3.45, p= 0.004). In group 2, on the contrary, Sa was similar at 6 months (9.02±4.26 versus 8.87±3.80 cm/sec, p=0.17) and at 18 months (9.02±4.26 versus 9.10±4.21cm/sec, p=0.06). Changes were not recorded in E/E' ratio between baseline and 18 months follow up (6.79±2.56 versus 6.81±2.62, p=0.15).
Conclusions: Bevacizumab has a direct adverse effect on both diastolic and systolic function of LV. Further studies are needed to confirm these findings and assess the effect of neovascularization inhibition on myocardium.
- © 2011 by American Heart Association, Inc.