Phasic Left Atrial Function in Cancer Patients Before Initiation of Anti-Cancer Therapy

Abstract

: We aimed to explore left atrial (LA) remodeling in the patients with solid cancer before initiation of chemo- or radiotherapy. This retrospective investigation included 92 chemo- and radiotherapy-naive cancer patients and 40 age- and gender-matched controls with a similar cardiovascular risk profile as the cancer group. All participants underwent comprehensive echocardiographic examination before the start of chemo- or radiotherapy. LA phasic function was evaluated in volumetric and strain method. Indexed minimal and pre-A LA volumes were significantly higher in the cancer patients. Total and passive LA emptying fraction (EF) were significantly lower, whereas active LAEF was significantly higher in the cancer patients. LA total longitudinal strain was significantly lower in the cancer patients. Strain rate analysis of LA phasic function showed that LA function during systole and early diastole was reduced in the cancer group, while it was increased during late diastole. These findings indicated that LA reservoir and conduit functions, assessed with LA volumetric and strain analysis, were deteriorated in the cancer group. On the other hand, LA booster pump function was elevated in the cancer group in comparison with the controls. In the whole population, cancer was associated with reduced LA total longitudinal strain independently of age, gender, BMI, LV hypertrophy, E/e’ ratio, diabetes, and hypertension. LA phasic function was impaired in the chemo- and radiotherapy-naive cancer patients in comparison with the control group. Cancer, LV hypertrophy, and hypertension were associated with reduced LA longitudinal strain independently of other important clinical parameters.

Quantification of left atrial function and geometry by cardiac magnetic resonance imaging in patients with severe aortic stenosis

“…Recent published data has proved similar associations between LV systolic dysfunction and LA enlargement and impairment [10,28,40]. Moreover, in our diseased group, LVEF's deterioration was closely related with LA dysfunction, similar to other reports [41].…”

A Prospective Study to Evaluate Cardiac Functions in Postmastectomy Left-Sided Breast Cancer Patients Receiving Doxorubicin Based Chemotherapy and Chest Wall Irradiation

“…In our study, mean value of RVEDV increaseis not statistically signicant (p=0.057), however the number of patients who shows increased in RVEDV was 12.72% (7 of 55) of the patients. Inpost RT phase the mean value increased to 137.26 SD ± 4.28 which was signicant (p=0.008) similar to other studies 16. Marijana Tadic et al reported greater diameter and higher volume among patients undergoing chemotherapy and radiation.…”

Left Atrial Geometry and Phasic Function Determined by Cardiac Magnetic Resonance Are Independent Predictors for Outcome in Non-Ischaemic Dilated Cardiomyopathy

“…LA conduit function was found to be defective even before LV hypertrophy and enlargement occurred [ 34 ], and to be directly associated with diastolic dysfunction, its severity [ 32 ] and progression [ 35 ]. Moreover, LA reservoir function was notably linked to cardiac dysfunction in diabetic [ 36 ] and cancer patients [ 37 ]. Additionally, the role of LA strain had been certified, being considerably linked to disease severity, HF hospitalization and mortality [ 38 ].…”