Abstract 12536: Changes In Pulsed Tissue Doppler Parameters Following Anthracycline-based Chemotherapy

Abstract

Background: Pulsed Tissue Doppler Imaging (TDI) is a validated tool for the assessment of systolic and diastolic function. Data about changes in pulsed-TDI parameters in patients (Pts) following Anthracycline(A)-based chemotherapy(CHT) is scarce.

Methods: 105 consecutive pts receiving A-based CHT(100pts for breast cancer- 5pts for lymphomas) were included in this prospective study. All Pts underwent an echocardiogram and clinical evaluation at baseline, at the end of A CHT, 3 and 9 months after the end of A CHT. 15 Pts receiving Trastuzumab were monitored with an extra echocardiogram 6 and 12 months after the end of A CHT in order to monitor Trastuzumab toxicity. We recorded pulsed Tissue Doppler imaging at the septal and lateral mitral annulus. Peak velocities in early diastole (E), late diastole( A),systole(S) and standard mitral inflow diastolic parameters were measured.

Results: At the end of follow-up (median 12.1 months, interquartile range 11.6-13.3) no pts developed clinical heart failure. Three pts (3.7%) had a mild decrease of ejection fraction (mean EF 50.3%) and 3 pts died due to progression of the underlying disease. There was a significant decrease in Evelocities and Svelocities and an increase of peak early diastolic mitral inflow velocity/Early diastole pulsed-TDI ratio (E/E) at the septal and lateral wall, indicating an adverse remodelling following A treatment. Changes in pulsed-TDI parameters are showed in Figure 1(* indicates p value<0.05 comparing with basal measurement).

Conclusions: Pulsed-TDI parameters changes following Anthracycline-based chemotherapy and may be used for early detection of Anthracycline cardiotoxicity.