Efficacy of Echocardiographic Parameters in Predicting Chemoradiotherapy-Induced Cardiotoxicity in Patients With Breast Cancer



Talebi A¹ ; Rajabi AB² ; Alizadehasl A³ ; Anbiaee R⁴ ; Khajetash B¹ ; Seilani P⁵ ; Ghavamzadeh A⁶
Source: Iranian Heart Journal Published:2023

Abstract

Objective: Using echocardiographic parameters, we sought to predict cardiotoxicity in patients with breast cancer before treatment. Methods: The study recruited 53 left-sided breast cancer patients with no previous history of heart failure or cancer treatment. The patients underwent 2D and 3D echocardiography before and 6 months after the end of treatment. The main criterion for cardiotoxicity was a reduction in posttreatment LVEF exceeding 10% compared with pretreatment. Systolic and diastolic parameters were compared between 2 groups: complicated and noncomplicated. Binary logistic regression was used to predict cardiotoxicity. Results: The patients’ mean age was 49 ± 11.2 years. No statistical differences existed between the groups in demographics and cardiac risk factors at study commencement. Posttreatment, 4 echocardiographic parameters (E/A ratio, sPAP, LVEF, and LVGLS) were significantly changed compared with pretreatment echocardiography. The regression analysis showed that E/A ratio was effective in predicting cardiotoxicity (sensitivity = 68%, specificity = 76%, AUC =77%; and P <0.001). Conclusions: Echocardiography, aside from its usefulness in diagnosing cardiotoxicity, can be valuable in predicting complications, especially in patients with breast cancer at higher risk of cardiotoxicity due to chemotherapy and radiotherapy in the chest wall area. © 2023, Iranian Heart Association. All rights reserved.