The prospects for applications of cardiometric approach in evaluation of cardiotoxicity under Anthracyclines therapy in patients with breast cancer
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The aim is to study the action and effects of antitumor polychemotherapy (PCT) with Anthracyclines on the cardiovascular system performance in primary oncological patients with breast cancer (BC).
Materials and methods
The study involved 21 females (49.8 ± 0.5 years) diagnosed with BC. PCT has been conducted in a neoadjuvant regimen in 18 patients and in an adjuvant one with Doxorubicin (60 mg/m2) and Cyclophosphamide (600 mg/m2) in 3 patients. The cardiovascular system functional state has been evaluated during six courses of PCT with the use of the Cardiocode device. At the same time, the conditions of the cardiovascular system have been assessed before PCT and during the fourth course using EchoCG and ECG.
Results and conclusions
Against the background of PCT with Anthracyclines noted are the cumulative changes in the blood vessel hemodynamics as reduced blood volumes ejected from the left ventricle and the atria and as alterations in the Rheogram signal. Observed is predominance of exchange of anaerobic energy over the aerobic one, characterized by a high level of the lactate concentration and accompanied by a decrease in the oxygen concentration on course 3, an increase in the phosphocreatine level on course 4 and its decrease during courses 5 and 6 of PCT. By the end of course 6 of PCT, a decline in adaptation functions and a disorder in compensatory processes in the myocardium against the background of development of uncompensated distress have been detected. Thus, the application of the cardiac cycle phase analysis method, along with the conventional methods for monitoring of the cardiovascular system performance, allows revealing disorders in its performance at early stages that is important for prevention of cardiovascular pathology, which may result from PCT.
Alla I. Shikhlyarova, Lyubov Y. Vladimirova, Natalia М. Tikhanovskaya, Yulia Y. Arapova, Tatiana P. Protasova, Elena А. Sycheva, Lyudmila А. Ryadinskaya, Aza А. Lyanova, Irina L. Popova, Natalia А. Abramova, Kristina А. Novoselova, Anna E. Storozhakova, Maria О. Ezhova, Yuliana S. Shatova, Aleksandr E. Lisutin, Viktoria V. Pozdnyakova, Irina R. Dashkova, Stella M. Babieva. The prospects for applications of cardiometric approach in evaluation of cardiotoxicity under Anthracyclines therapy in patients with breast cancer. Cardiometry; Issue 13; November 2018; p.15-21; DOI: 10.12710/cardiometry.2018.13.1521; Available from: http://www. cardiometry.net/issues/no13-november-2018/cardiotoxicity-under-anthracyclines-therapy