Analysis of the value of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and other parameters related to right heart function in detecting acute radiation-induced right heart injury

Li, Jinqiu; Wang, Likun; Liu, Hongqiang; Zhang, Zhilin; Dong, Shanglin; Zhang, Yunbo; Wu, Xiaochun; Ji, Xin; Ma, Hongxia; Ren, Chengbo

doi:10.21037/apm-21-1014

Cited by 3 publications

(5 citation statements)

References 22 publications

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“…Li et al. ( 27 ) observed an initial decrease in right heart function following radiotherapy for thoracic tumors. Xu et al.…”

Section: Discussionmentioning

confidence: 99%

Risk factors and prognostic analysis of right ventricular dysfunction after lung resection for NSCLC

Tan,

Tao,

Zhang

et al. 2024

Front. Oncol.

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ObjectivesLung cancer is the leading cause of cancer death, and 80–85% of all lung cancer cases are non-small cell lung cancer (NSCLC). Surgical resection is the standard treatment for early-stage NSCLC. However, lung resection, a surgical procedure, can result in complications and increased mortality. Recent studies have shown a significant correlation between complications after lung resection and right ventricular dysfunction.MethodsTransthoracic echocardiography-derived right ventricular-pulmonary artery coupling (RV-PAC) was utilized to assess right ventricular function in these patients. Multivariate logistic regression analysis was also conducted to assess risk factors independently associated with RV-PA uncoupling. The 3- and 5-year cumulative survival rates were estimated with Kaplan-Meier curves, and differences between groups were analyzed using the Mantel-Cox log-rank test.ResultsRV-PA uncoupling was defined as a TAPSE/PASP value < 0.67 mm/mm Hg according to spline analysis. The results of multivariable logistic regression analysis indicated that diabetes is an independent risk factor for right ventricular dysfunction after lung resection in patients with NSCLC. Kaplan-Meier analysis revealed a significant decrease in the survival rate of patients with RV-PA uncoupling at both the 3-year follow-up (73% vs 40%, p < 0.001) and 5-year follow-up (64% vs 37%, p < 0.001).ConclusionsAfter lung resection for NSCLC, the patient’s right ventricular function predicts prognosis. Patients with right ventricular dysfunction, particularly those with diabetes mellitus, have a worse prognosis. It is crucial to actively prevent and correct risk factors to reduce the mortality rate in these patients.

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“…Li et al. ( 27 ) observed an initial decrease in right heart function following radiotherapy for thoracic tumors. Xu et al.…”

Section: Discussionmentioning

confidence: 99%

Risk factors and prognostic analysis of right ventricular dysfunction after lung resection for NSCLC

Tan,

Tao,

Zhang

et al. 2024

Front. Oncol.

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“…There is a substantial lack of data about the effect of radiotherapy on RV remodeling in patients with other types of cancers. A study that included 70 patients with esophageal cancer, central lung cancer, thymoma and left breast cancer showed that TAPSE and the Tei index were sensitive indicators for the early detection of right heart injury after RT for thoracic tumors [5]. Nevertheless, the 3D RV ejection fraction revealed no significant change in the early stage of right heart damage after radiotherapy.…”

Section: Thoracic Cancers (Lung and Esophagus)mentioning

confidence: 98%

“…Nevertheless, various parts of the heart are radiated and affected differently, which mainly depends on tumor localization [1]. The majority of studies have investigated the effect of radiotherapy on the left ventricle (LV) [2,3], whereas the effect on the right ventricle (RV) has been studied significantly less [4][5][6]. Novel reports are more focused on subclinical LV changes that correspond with the deterioration of LV multidirectional strain [2,3].…”

Section: Introductionmentioning

confidence: 99%

Right Ventricle and Radiotherapy: More Questions than Answers

et al. 2023

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The injury of the left ventricle (LV) during anticancer therapy has long been recognized, and guidelines recommend a specific set of parameters for determination of LV impairment. The influence of anticancer therapy on the right ventricle (RV) has been insufficiently investigated, and there are only a few studies that have considered the effect of radiotherapy on RV remodeling. On the other hand, large number of patients with different types of cancers located in the chest are treated with radiotherapy, and the negative clinical effects of this treatment such as accelerated coronary artery disease, valve degeneration and heart failure have been documented. The anatomical position of the RV, which is in the front of the chest, is responsible for its large exposure during radiation treatment, particularly in patients with left-sided breast and lung cancers and mediastinal cancers (hematological malignancies, esophagus cancers, thymomas, etc.). For the same reason, but also due to its anatomical complexity, the RV remains under-investigated during echocardiographic examination, which remains the cornerstone of cardiac imaging in everyday practice. In the last decade many new echocardiographic imaging techniques that enable better evaluation of RV structure, function and mechanics appeared, and they have been used in detection of early and late signs of RV injuries in oncological patients. These investigations are related to some important restrictions that include limited numbers of patients, used parameters and imaging techniques. Many questions about the potential impact of these changes and possible predictions of adverse events remain to be evaluated in future large longitudinal studies. The current body of evidence indicates an important role of radiotherapy in RV remodeling, and therefore, the aim of this review is to summarize currently available data regarding RV changes in patients with various oncological conditions and help clinicians in the assessment of possible cardiac damage.

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“…Another study showed that 6 weeks after RT exposure, there was a small reduction in the global right ventricle strain and in the apical and the mid segments and that at 12 months there was a statistically significant GLS right-ventricle reduction [ 84 ]. Li J et al showed that the Tei index of the right ventricle and tricuspid annular displacement can be used as markers of right heart injury after RT for thoracic tumors [ 85 ].…”

Section: Cardiac Imaging Follow-up In Patients Receiving Rt For Breas...mentioning

confidence: 99%

“…In right-sided cancer, strain and tissue Doppler seem to decrease in the basal anterior left ventricle myocardium, but global heart function remains unchanged, while for left sided-breast cancer, changes in the apical territory, as well as a decline in GLS have been found. Those changes appear to be mirrored in some cases by ECG changes in the same territories and by slight increases in hs-cTnI and NTproBNP [ 85 ].…”

Section: Cardiac Imaging Follow-up In Patients Receiving Rt For Breas...mentioning

confidence: 99%

Accelerated Atherosclerosis and Cardiovascular Toxicity Induced by Radiotherapy in Breast Cancer

Stefan

Herghelegiu

Magda

2023

Life

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The number of patients diagnosed with breast cancer and cardiovascular disease is continuously rising. Treatment options for breast cancer have greatly evolved, but radiotherapy (RT) still has a key role in it. Despite many advances in RT techniques, cardiotoxicity is one of the most important side effects. The new cardio-oncology guidelines recommend a baseline evaluation, risk stratification and follow-up of these patients. Cardiotoxicity induced by RT can be represented by almost all forms of cardiovascular disease, with atherosclerosis being the most frequent. An interdisciplinary team should manage these patients, in order to have maximum therapeutic effect and minimum cardiovascular toxicity. This review will summarize the current incidence, risk factors, mechanisms and follow-up of RT-induced cardiovascular toxicity.

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Analysis of the value of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and other parameters related to right heart function in detecting acute radiation-induced right heart injury

Cited by 3 publications

References 22 publications

Risk factors and prognostic analysis of right ventricular dysfunction after lung resection for NSCLC

Risk factors and prognostic analysis of right ventricular dysfunction after lung resection for NSCLC

Right Ventricle and Radiotherapy: More Questions than Answers

Accelerated Atherosclerosis and Cardiovascular Toxicity Induced by Radiotherapy in Breast Cancer

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