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Right ventricular diastolic dysfunction in breast cancer patients undergoing chemotherapy


 
 
 Type of funding sources: None.
 Right ventricular (RV) diastolic dysfunction has been recognized as an independent predictor of adverse events and mortality in a wide range of diseases (1,2). Experimental and clinical data indicate that pathophysiological factors induce the development of RV diastolic dysfunction first, and only later - systolic dysfunction (3). The aim of the study was to assess the right ventricle diastolic function in patients with breast cancer undergoing chemotherapy.
 
 
 
 The study included 40 women receiving anthracycline-based chemotherapy for cancer, and 25 age-matched and comorbidity-matched women without cancer as a control group. RV systolic (s"t, Tei-index, and TAPSE) and diastolic (Et, At, Et/At, e"t, a"t, e"t/a"t) function parameters at baseline and after treatment were compared and evaluated.
 
 
 
 In cancer patients during anthracycline-based chemotherapy, no signs of cardiotoxicity were detected according to the indicators of the left ventricular ejection fraction and global longitudinal strain. Progressive decline in RV diastolic function was noted in patients receiving anticancer therapy. Et was 53.0 (46.0; 62.0) sm/sec in control, 50.0 (41.0; 53.0) sm/sec in cancer group before treatment, and  45.0 (41.0; 51.0) sm/sec after one-year treatment (p = 0.017 for trend). Et/At was 1.4 (1.28; 1.6), 1.34 (1.23; 1.58), and 1.12 (0.81; 1.35), respectively (p = 0.002 for trend). RV systolic function was without changes during treatment. TAPSE was 2.5 (2.2; 2.8) sm in control, 2.3 (2.2; 2.5) sm in cancer group before treatment, and  2.3 (2.0; 2.4) sm after one-year treatment (p = 0.091 for trend). 
 
 
 
 Patients undergoing chemotherapy experience a decline in right ventricular filling rates despite not showing clear signs of anthracycline-associated cardiotoxicity. More research is needed to indicate the clinical and prognostic significance of such changes.
