Abstract
Introduction Patients receiving chemotherapy for breast cancer may be at risk of developing cardiac dysfunction and electrophysiological abnormalities. The aim of this study is to evaluate alterations in electrocardiographic (ECG) parameters in breast cancer patients receiving chemotherapy. Materials and Methods This was a prospective single-center cohort study conducted in the Fourth Hospital of Hebei Medical University, China. Participants with breast cancer referred for chemotherapy from May 1, 2019, to October 1, 2019, were invited to participate in the study. Standard 12-lead ECG and echocardiography were performed at baseline or before chemotherapy (prechemotherapy) (T0), after 1 cycle (T1), after 3 cycles (T2), and at the end of chemotherapy (T3). Results A total of 64 patients with diagnosed breast cancer undergoing chemotherapy were included. Echocardiographic parameters showed no significant variation during the entire procedure (all P > 0.05). The incidence of abnormal ECG increased from 43.75% at baseline to 65.63% at the end of chemotherapy, of which only the prevalence of fragmented QRS (fQRS) was significantly increased after the drug regimen (26.56% to 53.13%). At the end of the treatment, heart rate, P-wave dispersion, corrected QT interval, T-peak to T-end, RR, SV1, RV5, Sokolow–Lyon index (SLI), and index of cardioelectrophysiological balance deteriorated markedly (all P < 0.05). The area under the curve for SLI and QT dispersion (QTd) derived by ECG was 0.710 and 0.606, respectively. The cutoff value with 2.12 of SLI by ECG had a sensitivity of 67.2% and specificity of 71.9% for differentiating patients after therapy from baselines. The cutoff value with 0.55 of QTd had a sensitivity of 60.9% and specificity of 60.9%. Conclusions The current study demonstrated that ECGs can be used to detect electrophysiological abnormalities in breast cancer patients receiving chemotherapy. ECG changes can reflect subclinical cardiac dysfunction before the echocardiographic abnormalities.
Highlights
Patients receiving chemotherapy for breast cancer may be at risk of developing cardiac dysfunction and electrophysiological abnormalities. e aim of this study is to evaluate alterations in electrocardiographic (ECG) parameters in breast cancer patients receiving chemotherapy
All patients received adjuvant chemotherapy after breast cancer surgery. e exclusion criteria were age under 18 years or over 80 years, other malignancies, a previous history of chemotherapy and radiation therapy (RT), pregnancy or breastfeeding, acute myocardial infarction within the previous 6 months, symptomatic heart failure (New York Heart Association Functional Classification III-IV), left ventricular ejection fraction (LVEF)
Electrocardiography. e incidence of abnormal ECG increased from 43.75% at baseline to 65.63% at the end of the treatment (Table 3). is was mainly due to a higher proportion of patients with fragmented QRS (fQRS) after chemotherapy (26.56% to 53.13%, P < 0.01)
Summary
Patients receiving chemotherapy for breast cancer may be at risk of developing cardiac dysfunction and electrophysiological abnormalities. e aim of this study is to evaluate alterations in electrocardiographic (ECG) parameters in breast cancer patients receiving chemotherapy. Patients receiving chemotherapy for breast cancer may be at risk of developing cardiac dysfunction and electrophysiological abnormalities. E aim of this study is to evaluate alterations in electrocardiographic (ECG) parameters in breast cancer patients receiving chemotherapy. E current study demonstrated that ECGs can be used to detect electrophysiological abnormalities in breast cancer patients receiving chemotherapy. One of the important side effects of chemotherapeutic agents used in patients with breast cancer is cardiotoxicity, which refers to cardiac dysfunction and heart failure [1]. It has been reported that standard 12-lead electrocardiogram (ECG) enables the detection of different findings of cardiotoxicity such as sinus tachycardia, ST-T wave abnormalities, cardiac conduction disorders, QT prolongation, fragmented QRS, and cardiac arrhythmia during chemotherapies in cancer patients [1, 4, 5]. The administration of chemotherapeutic agents may affect the cardiac electrophysiological properties before significant mechanical impairment. erefore, we aimed to evaluate the presence or absence of ECG abnormalities in patients newly diagnosed with breast cancer following chemotherapies
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