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- Open Access
Contemporary breast cancer chemotherapy leads to persistent late right ventricular myocardial dysfunction: a prospective multi-centre study
© Grover et al; licensee BioMed Central Ltd. 2013
- Published: 30 January 2013
- Breast Cancer
- Left Ventricle
- Right Ventricle
- Systolic Dysfunction
Previous studies evaluating cardiac effects of chemotherapy have focussed on the left ventricle (LV) and largely been retrospective. Although right ventricle (RV) systolic dysfunction is an adverse prognostic marker in cardiomyopathy states, the RV effects of chemotherapy are not well defined.
Thirty six breast cancer patients undergoing chemotherapy (26 anthracyline, 10 tranztumab) underwent serial CMR imaging (for LV and RV volumes/ejection fraction) and echocardiography for tricuspid annular systolic plane excursion (TAPSE) at baseline, 1, 3 and 12 months. RV impairment following chemotherapy was defined as an reduction of CMR RVEF below normal range (defined as 50%)1 and/or an absolute reduction of RVEF of at least 5% from baseline.
Functional changes following chemotherapy
1 month (n=33)
3 mths (n=33)
12 mths (n=21)
RV functional changes can be detected both early and late following current chemotherapy regimes using CMR and modern echocardiographic techniques. Although anthracyclines likely causes biventricular dysfunction, in our study they were more likely to cause persistent RV impairment at 12 months. These findings support routine surveillance of RV function in contemporary breast cancer chemotherapy.
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