Can serial changes of diastolic dysfunction signal incremental risk of chemotherapy-induced heart failure missed by the timing of declining LV ejection fraction?

Schwartz, Ronald G.; Venci, Nicholas

doi:10.1007/s12350-015-0194-4

Cited by 5 publications

(4 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…10,13,17,18 Limitations to the study include the fact that we did not assess LV diastolic function in our analyses. 4 As a result, it is uncertain how LV diastolic dysfunction impacts our results. Additionally, long-term follow-up of the participants is not yet available, and therefore the clinical relevance of these pre- to 3-month post-initiation of chemotherapy changes in LV volumes, EF, and mass are uncertain.…”

Section: Discussionmentioning

confidence: 92%

“…If one simply reports the LVEF, then those responsible for managing the patient receiving chemotherapy could inadvertently alter patient management for potentially incorrect reasons. For example, stopping potentially life-saving but cardiotoxic chemotherapy or initiation of cardio-protective medications that can lower blood pressure 4,16 may not be advised if the LVEF declined as a result of a decrease in LVEDV (or preload). In this situation, oral or intravenous hydration to restore intravascular volume, LV preload, and LVEF may be more appropriate.…”

Section: Discussionmentioning

confidence: 99%

“…1-4 It is often assumed that patients experiencing declines in LVEF during cancer treatment is related to cardiomyocyte injury promoting decreases in LV contractility that cause an increase in LV end-systolic volume (LVESV, Figure 1). 5-7 It is important to recognize that LVEF may also decline during cancer treatment 7,8 due to a decrease in LV end-diastolic volume (LVEDV) or pre-load related to hypovolemia (due to poor PO oral intake and or emesis, Figure 1).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Frequency of Left Ventricular End-Diastolic Volume–Mediated Declines in Ejection Fraction in Patients Receiving Potentially Cardiotoxic Cancer Treatment

Meléndez

Sukpraphrute

D’Agostino

et al. 2017

The American Journal of Cardiology

View full text Add to dashboard Cite

We sought to determine the frequency by which decreases in left ventricular (LV) end-diastolic volume (LVEDV) with and without increases in end-systolic volume (LVESV) influenced early cancer treatment-associated declines in left ventricular ejection fraction (LVEF) or LV mass. One hundred and twelve consecutively recruited individuals (aged 52 ± 14 years) with cancer underwent blinded cardiovascular magnetic resonance (CMR) measures of LV volumes, mass, and LVEF before and 3 months after initiating potentially cardiotoxic chemotherapy (72 % of participants received anthracyclines). Twenty-six participants developed important declines in LVEF of >10% or to values <50% at 3 months, in whom 19% versus 60%, respectively, experienced their decline in LVEF due to isolated declines in LVEDV versus an increase in LVESV; participants who dropped their LVEF due to decreases in LVEDV lost more LV mass than those who dropped their LVEF due to an increase in LVESV (p=0.03). Nearly a fifth of individuals experience marked LVEF declines due to an isolated decline in LVEDV after initiating potentially cardiotoxic chemotherapy. Since reductions in intravascular volume (which could be treated by volume repletion) may account for LVEDV related declines in LVEF, these data indicate that LV volumes should be reviewed along with LVEF when acquiring imaging studies for cardiotoxicity during treatment for cancer.

show abstract

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Frequency of Left Ventricular End-Diastolic Volume–Mediated Declines in Ejection Fraction in Patients Receiving Potentially Cardiotoxic Cancer Treatment

Meléndez

Sukpraphrute

D’Agostino

et al. 2017

The American Journal of Cardiology

View full text Add to dashboard Cite

show abstract

“…8 In addition, the measures of diastolic left ventricular dysfunction by means of ERNA can precede systolic dysfunction in chemotherapies and provide a more sensitive and specific predictor of longterm chemotherapy-induced heart failure. 35 The occurrence of right ventricular dysfunction is a well-known indicator of poor prognosis in patients with chronic cardiopulmonary disease. 36 Selimovic et al 36 performed a retrospective analysis of lung transplant candidates (n = 152) who had undergone ERNA, to determine baseline and exercise right ventricular ejection fraction.…”

Section: Journal Of Nuclear Cardiologyòmentioning

confidence: 99%

Equilibrium radionuclide angiography: Present and future

Romero-Farina

Aguadé-Bruix

2021

Journal of Nuclear Cardiology

View full text Add to dashboard Cite

This editorial refers to the article published by Sachpekidis et al 1 titled 'Equilibrium radionuclide angiography (ERNA): intra-and interobserver repeatability and reproducibility in the assessment of cardiac systolic and diastolic function' on the Journal of Nuclear Cardiology. The objective of this study was to assess the intra-and interobserver agreement in assessing the systolic and diastolic function with ERNA. The authors analyzed thirty-two adults underwent baseline and repeat ERNA. An experienced and a trainee operator analyzed the data by assigning regions of interest manually, fully automatically, and semi-automatically. The Bland-Altman statistic was used to assess the repeatability (two different assessments of a single acquisition) and reproducibility (assessments of two different acquisitions). According to the obtained results, the Authors concluded that: 'A good repeatability but a moderate reproducibility was found in the assessment of the left ventricular ejection fraction (LVEF). Less good were the findings in the assessment of diastolic function. The results also depended on the software tool'.This article provides interesting information about the intra-and interobserver repeatability and reproducibility in the assessment of cardiac systolic and diastolic function. Despite the fact that in the conclusions of this study the authors say that ERNA has a moderate reproducibility in the assessment of the LVEF; ERNA continues to be one of the best imaging techniques for the analysis of ventricular function. The analysis of the variability in the measurements of a technique is complex and not only depends on of the intra-and interobserver variability, but of other variabilities that are not generally taken into account, such as the day-to-day variability of the phenomenon studied, the variability of the pathology, age, gender, etc. In addition to this research study, it has a very heterogeneous population (men = 20, women = 12, heart failure = 13, cardiotoxic chemotherapy = 12, different degree of systolic dysfunction) in a small (n = 31) number of patients. Table 1 shows the reproducibility, and inter-and intra-observer variations of ERNA according to different acquisition methodology to evaluate left and right ventricular function. 1-7 ERNA has a high reproducibility, very low inter-or intra-observer variability, and high precision; it has been shown to be accurate when compared to other modalities and has strong early data that demonstrated efficacy in guiding the safety of treatment regimens, and it continues to be widely used for routine clinical monitoring. 8 This information is consistent with the comments of Sachpekidis et al. 9 in a previous review. Haarmark et al 10 evaluated 463 subjects without diabetes, previous potentially cardiotoxic chemotherapy, known cardiovascular or pulmonary disease, by means of Cadmium Zinc Telluride (CZT) SPECT camera. They conclude that there are age-related changes in cardiac dimensions with age depending on gender, although with only

show abstract

The role and clinical effectiveness of multimodality imaging in the management of cardiac complications of cancer and cancer therapy

Russell

Alexander

Jain

et al. 2016

Journal of Nuclear Cardiology

View full text Add to dashboard Cite

With the increasing number of individuals living with a current or prior diagnosis of cancer, it is important for the cardiovascular specialist to recognize the various complications of cancer and its therapy on the cardiovascular system. This is true not only for established cancer therapies, such as anthracyclines, that have well established cardiovascular toxicities, but also for the new targeted therapies that can have "off target" effects in the heart and vessels. The purpose of this informational statement is to provide cardiologists, cardiac imaging specialists, cardio-oncologists, and oncologists an understanding of how multimodality imaging may be used in the diagnosis and management of the cardiovascular complications of cancer therapy. In addition, this document is meant to provide useful general information concerning the cardiovascular complications of cancer and cancer therapy as well as established recommendations for the monitoring of specific cardiotoxic therapies.

show abstract

Can serial changes of diastolic dysfunction signal incremental risk of chemotherapy-induced heart failure missed by the timing of declining LV ejection fraction?

Cited by 5 publications

References 32 publications

Frequency of Left Ventricular End-Diastolic Volume–Mediated Declines in Ejection Fraction in Patients Receiving Potentially Cardiotoxic Cancer Treatment

Frequency of Left Ventricular End-Diastolic Volume–Mediated Declines in Ejection Fraction in Patients Receiving Potentially Cardiotoxic Cancer Treatment

Equilibrium radionuclide angiography: Present and future

The role and clinical effectiveness of multimodality imaging in the management of cardiac complications of cancer and cancer therapy

Contact Info

Product

Resources

About