Diastolic Dysfunction Following Anthracycline-Based Chemotherapy in Breast Cancer Patients: Incidence and Predictors

Serrano, José María González; González, I.; Castillo, Silvia del; Muñiz, Javier; Morales, Luis J.; Cuadro, Fernando Moreno; Jiménez, Rosa María Rodríguez; Cristóbal, Carmen; Graupner, Catherine; Talavera, P.; Curcio, Alejandro; Martinez, Paula Felippe; Guerra, Juan Antonio; Alonso, Joaquín

doi:10.1634/theoncologist.2014-0500

Cited by 58 publications

(34 citation statements)

References 31 publications

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“…Recently, it has been observed that diastolic dysfunction can be present early during the course or after ending chemotherapy, in the absence of clear clinical signs that may prognosticate heart failure (HF) (Prestor et al, 2000;Elli et al, 2013;Minotti, 2013). In both adult and paediatric patients, diastolic dysfunction, as the earliest manifestation of doxorubicin cardiotoxicity, is associated with impaired active relaxation and elevated passive stiffness leading to left ventricle (LV) dysfunction that first appears during diastole and subsequently involves systole (Carver et al, 2007;Salvatorelli et al, 2015;Serrano et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Effects of ranolazine in a model of doxorubicin‐induced left ventricle diastolic dysfunction

Cappetta

Esposito

Coppini

et al. 2017

British J Pharmacology

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Doxorubicin is a highly effective anticancer drug, but its clinical application is hampered by cardiotoxicity. Asymptomatic diastolic dysfunction can be the earliest manifestation of doxorubicin cardiotoxicity. Therefore, a search for therapeutic intervention that can interfere with early manifestations and possibly prevent later development of cardiotoxicity is warranted. Increased doxorubicin-dependent ROS may explain, in part, Ca 2+ and Na + overload that contributes to diastolic dysfunction and development of heart failure. Therefore, we tested whether the administration of ranolazine, a selective blocker of late Na + current, immediately after completing doxorubicin therapy, could affect diastolic dysfunction and interfere with the progression of functional decline. EXPERIMENTAL APPROACHFischer 344 rats received a cumulative dose of doxorubicin of 15 mg·kg À1 over a period of 2 weeks. After the assessment of diastolic dysfunction, the animals were treated with ranolazine (80 mg·kg À1 , daily) for the following 4 weeks. KEY RESULTSWhile diastolic and systolic function progressively deteriorated in doxorubicin-treated animals, treatment with ranolazine relieved diastolic dysfunction and prevented worsening of systolic function, decreasing mortality. Ranolazine lowered myocardial NADPH oxidase 2 expression and oxidative/nitrative stress. Expression of the Na + /Ca 2+ exchanger 1 and Na v 1.5 channels was reduced and of the sarcoplasmic/endoplasmic reticulum Ca 2+ -ATPase 2 protein was increased. In addition, ranolazine lowered doxorubicin-induced hyper-phosphorylation and oxidation of Ca 2+ /calmodulin-dependent protein kinase II, and decreased myocardial fibrosis. CONCLUSIONS AND IMPLICATIONSRanolazine, by the increased Na + influx, induced by doxorubicin, altered cardiac Ca 2+ and Na + handling and attenuated diastolic dysfunction induced by doxorubicin, thus preventing the progression of cardiomyopathy. LINKED ARTICLES

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Section: Introductionmentioning

confidence: 99%

Effects of ranolazine in a model of doxorubicin‐induced left ventricle diastolic dysfunction

Cappetta

Esposito

Coppini

et al. 2017

British J Pharmacology

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“…According to Cardonick et al [38], it is preferable to use Doxorubicin rather than Epirubicin, the latter having more adverse effects. Fetal cardiotoxicity due to in utero exposure to anthracyclines reported by other studies [4,39], was ruled out by subsequent research which assessed in utero cardiac function and postpartum newborn cardiac function [3,40].…”

Section: Surgerymentioning

confidence: 99%

The role of imaging techniques in the diagnosis, staging and choice of therapeutic conduct in pregnancy associated breast cancer

et al. 2019

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Breast cancer diagnosed during pregnancy is at increasing incidence due to the increased frequency of obesity, the postponement of the first pregnancy to later decades of life and the advances of diagnostic techniques. Clinical and imaging diagnosis is difficult during gestation due to adaptive changes of the maternal organism , the mammary glads in particular. Furthermore, the therapeutic approach is limited both by the possible side effects on the fetus and by the skepticism of the couple over these therapeutic regimens.The present paper aims to review the main diagnostic steps to confirm pregnancy associated breast cancer, as well as the therapeutic possibilities during this period, related to the potential adverse effects concerning pregnancy

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“…В частности, через 6 лет после терапии антрациклинами и трастузумабом наблюдалось снижение отношения E/A (0,9±0,3 против 1,1±0,3, p=0,003), скорости пика E' (10,2 ± 2 против 11,2 ± 2,3, p=0,036) по сравнению с группой контроля [6]. Следует отметить, что пациенты, имеющие нормальную диастолическую функцию после химиотерапии, в дальнейшем не имели снижение систолической функции ЛЖ (период наблюдения 9 месяцев после курса антрациклина и трастузумаба) [7]. Несмотря на то, что диастолическая функция, как правило, появляется раньше систолической на фоне [1].…”

Section: двухмерная эхокардиографияunclassified

Methods of diagnosis in cardio-oncology

Plokhova

Владимировна²,

Сорокин

et al. 2018

Journal of Clinical Practice

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Early diagnosis and advances in treatment have led to improved survival of patients with cancer, but have also increased morbidity and mortality due to treatment side effects. Cardiovascular diseases (CVDs) are one of the most frequent of these side effects. As a result of the direct effects of radiation therapy and chemotherapy on heart and vessels сan be: acceleration of atherosclerosis, damage of cardiomyocytes and endothelium, and arterial and venous thrombosis. The direct effect of the cancer treatment on the heart is called cardiotoxicity. Early diagnosis and identification of patients at high risk of cardiotoxicity is the first step towards successful prevention of CVD in cancer patients without compromising cancer care, which ultimately leads to a reduction in mortality. Echocardiography is the method of choice for the detection of myocardial dysfunction during and after cancer therapy. New methods of imaging like three-dimensional echocardiography, speckle-tracking echocardiography, cardiac magnetic resonance show a higher sensitivity in detecting of early myocardial dysfunction during cancer therapy. This review outlines the main diagnostic algorithms and approaches used in cardiooncology.

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Diastolic Dysfunction Following Anthracycline-Based Chemotherapy in Breast Cancer Patients: Incidence and Predictors

Cited by 58 publications

References 31 publications

Effects of ranolazine in a model of doxorubicin‐induced left ventricle diastolic dysfunction

Effects of ranolazine in a model of doxorubicin‐induced left ventricle diastolic dysfunction

The role of imaging techniques in the diagnosis, staging and choice of therapeutic conduct in pregnancy associated breast cancer

Methods of diagnosis in cardio-oncology

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