Abstract
BackgroundChemotherapy induced cardio-toxicity has been recognized as a serious side effect since the first introduction to anthracyclines (ANT). Cardio-toxicity among patients with breast cancer is well studied but the impact on patients with sarcoma is limited, even though they are exposed to higher ANT doses. The commonly used term for cardio-toxicity is cancer therapeutics related cardiac dysfunction (CTRCD), defined as a left ventricular ejection fraction (LVEF) reduction of > 10%, to a value below 53%. The aim of our study was to estimate the prevalence of CTRCD in patients diagnosed with sarcoma and to describe the baseline risk factors and echocardiography parameters among that population.MethodsData were collected as part of the Israel Cardio-Oncology Registry (ICOR), enrolling all patients evaluated in the cardio-oncology clinic at our institution. The registry was approved by the local ethics committee and is registered in clinicaltrials.gov (Identifier: NCT02818517). All sarcoma patients were enrolled and divided into two groups - CTRCD group vs. non-CTRCD group.ResultsAmong 43 consecutive patients, 6 (14%) developed CTRCD. Baseline cardiac risk factors were more frequent among the non-CTRCD group. Elevated left ventricular end systolic diameter and reduced Global Longitudinal Strain were observed among the CTRCD group. During follow-up, 2 (33%) patients died in the CTRCD group vs. 3 (8.1%) patients in the non-CTRCD group.ConclusionsCTRCD is an important concern among patients with sarcoma, regardless of baseline risk factors. Echocardiography parameters may provide an early diagnosis of cardio-toxicity.
Highlights
Chemotherapy induced cardio-toxicity has been recognized as a serious side effect since the first introduction to anthracyclines (ANT)
Shamai et al BMC Cancer (2020) 20:609 toxicity has been well studied among patients with breast cancer, [6] there is limited data regarding the risk for cardiac dysfunction and its related mortality among patients with sarcoma [7], even though the latter are exposed to higher doses of cardio-toxic chemotherapy
The most common baseline risk factors were hypertension (37%) and hyperlipidemia (19%) and 11 (26%) patients were treated with baseline cardio-protective therapy including Angiotensin II receptor blockers (ARB), angiotensin-converting-enzyme inhibitors (ACEI) or beta blockers (BB)
Summary
Chemotherapy induced cardio-toxicity has been recognized as a serious side effect since the first introduction to anthracyclines (ANT). The commonly used term for cardio-toxicity is cancer therapeutics related cardiac dysfunction (CTRCD), defined as a left ventricular ejection fraction (LVEF) reduction of > 10%, to a value below 53%. Shamai et al BMC Cancer (2020) 20:609 toxicity has been well studied among patients with breast cancer, [6] there is limited data regarding the risk for cardiac dysfunction and its related mortality among patients with sarcoma [7], even though the latter are exposed to higher doses of cardio-toxic chemotherapy. According to the American and European Society of Echocardiography Expert Consensus, a left ventricular ejection fraction (LVEF) reduction of > 10%, to a value below 53% is defined as cancer therapeutics related cardiac dysfunction (CTRCD) [5]. Novel techniques for early detection of myocardial damage are required
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