Abstract 13747: Diastolic Dysfunction Following Anthracycline-based Chemotherapy
Background: As in other conditions diastolic dysfunction (DD) may precede systolic changes and may be an early manifestation of antraciclyne chemoteraphy cardiotoxicity. Data about the evolution of diastolic function following anthracycline treatment are scant.
Methods: 105 consecutive patients (pts) receiving Anthracycline (A)-based chemotherapy (CHT) (96% for breast cancer) were included in this prospective study. All pts underwent clinical evaluation, an echocardiogram and blood test at baseline, at the end of A CHT, 3 and 9 months after the end of A CHT. We collected clinical data, systolic and diastolic parameters (pulsed Tissue Doppler imaging at mitral annulus, color M-mode propagation velocity and standard mitral inflow diastolic parameters), cardiac biomarkers including high-sensitivity Troponin T (TnT), NTproBNP and Heart-type fatty acid binding protein (H-FABP). Sixteen pts with baseline DD were excluded from the analysis.
Results: At the end of follow-up (median 12.1 months, interquartile range 11.6-13.3), 3 pts (3.4%) had a mild decrease of ejection fraction. Fifty-one pts (57%) developed diastolic dysfunction and 38 pts (43%) didn’t develop significant diastolic changes. Comparing groups of pt developing (DD+) and not developing DD (DD-) we found that DD was associated with age, BMI and with higher TnT and H-FABP levels at 3 months post A CHT, but not at the visit at the end of A CHT. We found no differences between both groups in the presence of classical vascular risk factors (Hypertension, diabetes, hyperlipidemia and smoking). Clinical and biochemical parameters in pts DD+ and DD- are showed in figure 1. By the end of follow up DD persisted in 37 pts (41%) and reversed in 14 pts (16%).
Conclusions: Development of diastolic dysfunction following Anthracycline chemotherapy is common and is more frequent in aged and overweight/obese patients. TnT and H-FABP might be helpful to monitor cardiac toxicity related to Anthracycline chemotherapy.
- © 2013 by American Heart Association, Inc.