OR65. The Effect of Carvedilol on Subclinical Left Ventricular Dysfunction after Chemotherapy of FAC Regimen in Breast Cancer Patients : An Experimental Study

Abstract

Background Breast cancer survivors potentially develop cardiotoxicity after FAC regiment administration. Carvedilol may provide antioxidant, antiapoptotic, and myocyte-calcium regulation effects in chemotherapy. This study aimed to evaluate cardioprotective effects of Carvedilol towards preventing subclinical left ventricular dysfunction (SLVD) in breast cancer patients following FAC chemotherapy. Methods The study was a prospective open-label and Quasi-Experimental. We divided the patients receiving the FAC chemotherapy from September 2018 until May 2019 into intervention (IG) and control groups (CG). The IG received Carvedilol 6.25 mg b.i.d. up titrated every three weeks until the tolerated dose. We evaluated the left ventricular GLS changes and the incidence of SLVD (GLS reduction ≥15% and GLS >-18%) at 24 weeks after the FAC regimen initiation. Result Eighty-one women were enrolled in the study; 31 of them were the IG. There were no significant GLS changes during and after FAC completion in the IG, while the CG showed contradictive. At the end of follow-up, the delta GLS reduction was lower in the IG 0.7 (95% CI – 0.60,3.60) than the CG 3.00 (95% CI – 2.16,4.19), p = 0.035. The GLS percentage reduction showed similar results with 3.6% and 14.29% in the IG and CG respectively with p = 0.05. The incidence rate of SLVD (GLS reduction ≥15% and GLS >-18%) in IG was lower; 41.9% and 25.8%, while in the CG was 58% and 48%. Conclusion Carvedilol may have a cardioprotective effect by preventing the GLS reduction and reducing the incidence of SLVD in women with breast cancer after a complete cycle of FAC regimen.

At the Intersection of Cardiology and Oncology: TGFβ as a Clinically Translatable Therapy for TNBC Treatment and as a Major Regulator of Post-Chemotherapy Cardiomyopathy

“…Cardiac function was assessed using left ventricular global longitudinal strain (GLS) and subclinical left ventricular ejection fraction (SVLEF). The IG group had a smaller drop in GLS and LVEF compared to the control group, suggesting a cardioprotective effect of carvedilol [126].…”