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Dynamics of echocardiographic parameters during neoadjuvant chemotherapy in patients with breast cancer

Authors: Buziashvili Yu.I., Asymbekova E.U., Matskeplishvili S.T., Tugeeva E.F., Artamonova E.V., Akildzhonov F.R.

Company: 1 Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation
2 N.N. Blokhin National Medical Research Center of Oncology, Moscow, Russian Federation
3 N.I. Pirogov Russian National Research Medical University, Moscow, Russian Federation
4 M.F. Vladimirsky Moscow Regional Research Clinical Institute, Moscow, Russian Federation

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Type:  Original articles


DOI: https://doi.org/10.24022/1997-3187-2022-16-4-520-532

For citation: Buziashvili Yu.I., Asymbekova E.U., Matskeplishvili S.T., Tugeeva E.F., Artamonova E.V., Akildzhonov F.R. Dynamics of echocardiographic parameters during neoadjuvant chemotherapy in patients with breast cancer. Creative Cardiology. 2022; 16 (4): 520–32 (in Russ.). DOI: 10.24022/1997-3187-2022-16-4-520-532

Received / Accepted:  31.05.2022 / 28.11.2022

Keywords: cardiotoxicity tissue dopplerography neoadjuvant chemotherapy

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Abstract

Objective. To analyze the dynamics and determine specific echocardiographic indicators of subclinical cardiotoxicity during neoadjuvant chemotherapy (NAC).

Material and methods. The prospective study included 72 patients with a confirmed diagnosis of breast cancer (BC) during NAC from March 2021 to February 2022, the mean age was 47.9 ± 11.9 years. All patients underwent 2D and M-mode echocardiography, pulsed wave and tissue dopplerography before the start of NAC, during the course (3 weeks) and after the completion of chemotherapy. Left ventricular (LV) systolic and diastolic function were assessed. Peak longitudinal deformation of the LV and left atrium (LA) in various projections were analyzed using the Qlab workstation.

Results. During the period of NAC, at the stage of the interim study, an increase in the end systolic volume (ESV) index by 9% was noted. After the end of NAС – an increase in the ESV index by 12%. The LV ejection fraction decreased by 8.3% after the end of NAC (p = 0.00001). There was an increase in the segmental contractility impairment index from 1.0 ± 0.3 to 1.2 ± 0.2 after the end of NAC (p = 0.00001). The integral index E/e, which correlates with LA pressure, increased after chemotherapy, which is an indicator of diastolic myocardial dysfunction. When analyzing the deformation properties of the LA, a significant deterioration in the positive global deformation (GSA+) of 11.08% and 9.9% was observed (p = 0.02) compared with baseline and negative global deformation (GSA-) of 0.35% and 0.14% (p = 0.00006) compared to baseline.

Conclusion. NAC undoubtedly causes changes in systolic and diastolic function, a decrease in LV and LA myocardial deformity.

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About Authors

  • Yuriy I. Buziashvili, Dr. Med. Sci., Professor, Academician of Russian Academy of Sciences, Head of Department; ORCID
  • El’mira U. Asymbekova, Dr. Med. Sci., Leading Researcher; ORCID
  • Simon T. Matskeplishvili, Dr. Med. Sci., Professor, Corresponding Member of Russian Academy of Sciences, Chief Researcher; ORCID
  • El’vina F. Tugeeva, Dr. Med. Sci., Senior Researcher; ORCID
  • Elena V. Artamonova, Dr. Med. Sci., Leading Researcher; ORCID
  • Firdavsdzhon R. Akildzhonov, Postgraduate; ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


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