Echocardiography-Assessed Changes of Left and Right Ventricular Cardiac Function May Correlate with Progression of Advanced Lung Cancer-A Generating Hypothesis Study.

Abstract

Simple SummaryLung cancer often coexists with cardiovascular diseases. Due to its specific location, lung cancer affects pulmonary circulation and leads to symptoms of dyspnea. If lung cancer is in an inoperable stage, the early response to cancer treatment determines prognosis. There are studies showing that advanced cancer, especially lung cancer, can be interpreted as advanced heart failure. This publication confirms that the progression of advanced inoperable lung cancer affects a number of parameters of right and left ventricular function. Importantly, the diagnosis of tumor progression may occur at the same time as the diagnosis of a cardiotoxic effect of cancer treatment. Cardio-oncology specialists should plan further research into these correlations and possible preventive strategies or care management.Advanced lung cancer causes damage to lung tissue and the alveolar–capillary barrier, leading to changes in pulmonary circulation and cardiac function. This observational study included 75 patients with inoperable lung cancer. Two echocardiographic assessments were performed: one before the initiation of systemic anticancer therapy and another after the first radiological evaluation of the efficacy of anticancer treatment. In retrospective analysis, diagnosis of early cancer progression was associated significantly (p < 0.05) with some echocardiographic changes: a decrease in EF of at least 5 percentage points (OR = 5.78), an increase in LV GLS of 3 percentage points (OR = 3.81), an increase in E/E′ ratio of at least 3.25 (OR = 3.39), as well as a decrease in RV free wall GLS of at least 4 percentage points (OR = 4.9) and an increase in FAC of at least 4.1 percentage points (OR = 4.9). Cancer therapeutics-related cardiac dysfunction was diagnosed in accordance with the definition of the International Cardio-Oncology Society and was found more frequently in patients with radiologically confirmed lung cancer disease progression (p = 0.003). In further prospective studies, the hypothesis about the possible coexistence of the cardiotoxic effect of cancer therapy and cardiac dysfunction related to the progression of inoperable lung cancer should be clarified.