The impact of right ventricular function on prognosis in patients with stage III non-small cell lung cancer after concurrent chemoradiotherapy

Chen, Lu; Huang, Jing-Juan; Wu, Weihua; Ta, Shengjun; Xie, Xing

doi:10.1007/s10554-019-01590-0

Cited by 22 publications

(21 citation statements)

References 40 publications

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“…3,18 Similar to LV strain, STE-derived RV longitudinal strain has been shown to be feasible, reproducible and prognostic in oncological patients. 13,19,20 Due to less load dependent and less angle dependent than conventional parameters, RV FWLS has recently been proposed to evaluate RV dysfunction. In our study, 3D RV GLS and RV FWLS decreased during and after anthracycline chemotherapy.…”

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confidence: 99%

Assessment of Subclinical Deterioration of Right Ventricular Function by Three-Dimensional Speckle Tracking Echocardiography in Breast Cancer Patients Undergoing Anthracycline-Based Chemotherapy

Xu¹,

Mao²,

Liu³

et al. 2021

IJGM

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Objective: This study was aimed at assessing the longitudinal strain changes of RV function using three-dimensional speckle tracking echocardiography (3D STE) in breast cancer patients receiving anthracycline chemotherapy. Patients and Methods: A total of 95 women with breast cancer receiving epirubicin (360 mg/m 2) underwent 3D STE at baseline, the end of chemotherapy and 12 months after chemotherapy. 3D STE assessment included RV ejection fraction (EF), LV global longitudinal strain (GLS), RV GLS, and RV free wall longitudinal strain (RV FWLS). Meanwhile, serum hs-cTnI and NT-proBNP were measured. Chemotherapy-related cardiac dysfunction (CTRCD) was defined as an absolute decrease in 3D LVEF > 10% to a value <50%, while a percent reduction of 3D LV GLS > 15% indicated subclinical CTRCD. Results: Subclinical CTRCD occurred in 10 (10.5%) patients during follow-up. Compared to baseline, the 3D GLS of LV and GLS and FWLS of RV decreased significantly at 12months after chemotherapy (all p<0.01). Variations of 3D RV GLS and RV FWLS had a good discrimination for predicting subclinical CTRCD. The variation of 3D RV FWLS was the only independent predictor of subclinical CTRCD (OR, 1.37; 95% CI, 1.12-2.87; p = 0.028) in multivariate analysis. The cutoff value with −17.5% of 3D RV FWLS variation had a high predictive accuracy for subclinical CTRCD, with an AUC of 0.74, 80.5% sensitivity and 65.8% specificity. The association between 3D RV FWLS and the cumulative dose of anthracyclines was calculated by Spearman's test (r = −0.71, p < 0.001). Conclusion: Longitudinal strain analysis by 3D STE allows the identification of subclinical RV dysfunction when conventional indices of RV function are unaffected. 3D RV FWLS was superior to other parameters in early detection of the development of CTRCD in breast cancer patients receiving epirubicin therapy.

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confidence: 99%

Assessment of Subclinical Deterioration of Right Ventricular Function by Three-Dimensional Speckle Tracking Echocardiography in Breast Cancer Patients Undergoing Anthracycline-Based Chemotherapy

Xu¹,

Mao²,

Liu³

et al. 2021

IJGM

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“…The study by Chang WT et al [15] demonstrated that the value of the RV free wall longitudinal strain after the first course of epirubicin in patients with breast cancer was significantly reduced and was associated with the onset of dyspnea symptoms, which was not observed for other echocardiographic parameters. The independent prognostic value of this parameter was also shown in patients with non-small cell lung cancer of stage III during the ongoing chemo-radiation therapy; the worst prognosis was in patients with a decrease of ≥10.1% from the baseline value prior to the therapy [16]. Nevertheless, we conclude with some reservation that it is advisable to study the RV strain parameters in cancer patients to assess the cancer therapy cardiotoxicity [14].…”

Section: Essential Facts About Studies Evaluating Rv Function Vs Cardiac Toxicity Diagnosingmentioning

confidence: 57%

Evaluating Right Ventricular Function To Reveal Cancer Therapy Cardiotoxicity

Sumin

2021

Russ Open Med J

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Advances in cancer treatment resulted in augmented patient survival rate. However, anticancer therapy often causes heart damage in the form of a progressive systolic heart failure. Echocardiographic parameters of left ventricular function were conventionally used to detect early manifestations of cancer therapy cardiotoxicity. Improved diagnosing of the right ventricle condition revealed that it is negatively affected by chemotherapy as frequently as the left ventricle, and sometimes even earlier than the latter. Hence, currently, the right ventricle function and mechanics assessment techniques are actively developed for the chemotherapy cardiotoxicity diagnostic, primarily employing 3D echocardiography and speckle tracking analysis. The presented review provides relevant information on the matter and highlights insufficiently developed issues and fields of further research.

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“…RV LS is a valuable marker for cardiac injury in patients with cancer under cardiotoxic treatment [42]. However, the prognostic significance of echocardiographic changes in RV function remains rather debatable [41][42][43]. In this context, the assessment of RV LS in patients with MM under carfilzomib-based treatment may serve as an early marker for RV cardiotoxicity in the clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Daratumumab May Attenuate Cardiac Dysfunction Related to Carfilzomib in Patients with Relapsed/Refractory Multiple Myeloma: A Prospective Study

Terpos

Stamatelopoulos

Makris

et al. 2021

Cancers

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Carfilzomib has improved survival in patients with relapsed/refractory multiple myeloma (RRMM), but it may exert cardiovascular adverse events (CVAEs). The aim of this study was to assess whether treatment with daratumumab may ameliorate carfilzomib-related toxicity. We prospectively evaluated 25 patients with RRMM who received either daratumumab in combination with carfilzomib and dexamethasone (DaraKd) (n = 14) or Kd (n = 11). Cardiac ultrasound was performed before treatment initiation and C6D16 or at the time of treatment interruption. Patients were followed for a median of 10 months for CVAEs. The mean (± SD) age was 67.8 ± 7.6 years and 60% were men. The two treatment groups did not significantly differ in baseline demographic characteristics (p > 0.1 for all). In the DaraKd group, we did not observe any significant change in markers of ventricular systolic function. However, these markers deteriorated in the Kd group; left ventricular (LV) ejection fraction, LV global longitudinal strain, tricuspid annular plane systolic excursion and RV free wall longitudinal strain significantly decreased from baseline to second visit (p < 0.05). A significant group interaction (p < 0.05) was observed for the abovementioned changes. CVAEs occurred more frequently in the Kd than the DaraKd group (45% vs. 28.6%). DaraKd was associated with preserved post-treatment cardiac systolic function and lower CVAE rate compared with Kd. The clinical significance and the underlying mechanisms merit further investigation.

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The impact of right ventricular function on prognosis in patients with stage III non-small cell lung cancer after concurrent chemoradiotherapy

Cited by 22 publications

References 40 publications

Assessment of Subclinical Deterioration of Right Ventricular Function by Three-Dimensional Speckle Tracking Echocardiography in Breast Cancer Patients Undergoing Anthracycline-Based Chemotherapy

Assessment of Subclinical Deterioration of Right Ventricular Function by Three-Dimensional Speckle Tracking Echocardiography in Breast Cancer Patients Undergoing Anthracycline-Based Chemotherapy

Evaluating Right Ventricular Function To Reveal Cancer Therapy Cardiotoxicity

Daratumumab May Attenuate Cardiac Dysfunction Related to Carfilzomib in Patients with Relapsed/Refractory Multiple Myeloma: A Prospective Study

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