Early Diagnosis of Cardiac Toxicity Related to Antineoplastic Treatment

Background: breast cancer because of radiotherapy and/or chemotherapy causes cardiac disease, often it occurs on women just affected by hypertension and/or diabetes. All these conditions may affect left ventricular (LV) geometry, mass and diastolic function. The purpose of this study is to early detect these affections to improve heart failure prevention. Patients and methods: 134 women, affected by breast cancer, underwent to conventional transthoracic echocardiography (TTE) and pulse wave tissue Doppler imaging (PW-TDI). A control group (CG) of 80 women unaffected by breast cancer, hypertension and diabetes was enrolled. Results: 54 of 134 women (40.2%), were affected by hypertension or diabetes too (Prone Group = PG), 8 by both, 80 (59.8%) were free (FG). Mean age of all patients was 45.4 years. The rates of LV eccentric hypertrophy and LV distolic dysfunction were statistically significant higher on FG group than controls, and on PG group than FG group. Conclusions: an abnormal LV diastolic function is more common among women affected by breast cancer after treatment than in general population, the same for LV eccentric hypertrophy but at a lower rate. 40% of women were affected by hypertension, diabetes or both, and as expected they have a higher rate of LV eccentric hypertrophy and diastolic dysfunction. This high prevalence of LV eccentric hypertrophy and diastolic dysfunction, on asymptomatic women, affected by breast cancer, is a predictor of heart failure; Doppler-echo techniques may be helpful in early diagnosis.