Jongeneel, J.N.M. (2017) Afwijkende “strain” van het linker ventrikel bij echocardiografie als vroeg teken van hartschade bij patiënten behandeld met adjuvante radiotherapie en anthracycline-bevattende chemotherapie voor borstkanker. thesis, Medicine.
Full text available on request.Abstract
Background Both chemo- and radiotherapy as adjuvant treatment for breast cancer may lead to cardiac dysfunction, resulting in ischemia and/or heart failure. De sensitivity of left ventricular ejection fraction (LVEF) for subclinical left ventricular damage is low. Analysis of strain, indicative of the deformation of the myocardium, may provide a better alternative. Methods In this retrospective analysis of 700 participants (350 treated for breast cancer, 350 healthy, matched controls, both recruited from a primary care setting) in the BLOC study (‘Breast Cancer Long-term Outcome of Cardiac Dysfunction’, ClinicalTrials.gov NCT01904331), echocardiograms were retrospectively analyzed for the global longitudinal strain (GLS) of the left ventricle (LV), using speckle tracking with TomTec Imaging Systems GmbH Arena 2 (Munich, Germany). The obtained LV GLS values were compared between treated patients and controls, as well as in subgroups (patients treated with chemo- +/- radiotherapy or radiotherapy). Results LV GLS values were obtained from 258 participants during this internship period. The median age of this cohort was 62. The cohort was composed of 124 control-participants (median age 62), 62 patients from the chemotherapy group (median age 58) and 72 patients from the radiotherapy group (median age 65). The mean LV GLS was -16,92% (n = 134) for treated breast cancer patients (chemotherapy group -17,21%, radiotherapy group -16,67%) and -16,99% (n = 124) for controls (absolute difference 0,07%, p = 0,83). LV GLS correlates with LVEF (systolic function parameter) and e’ (diastolic function parameter). The analyzed population was younger, had more right-sided breast cancer and less cardiovascular risk factors than the entire BLOC population. Conclusions There was no significant difference in LV GLS between treated patients and controls. The treatment modality did not make a significant difference in obtained GLS when comparing the patients and controls in subgroups. LV GLS does seem to be related to left ventricular damage. LV GLS could still be a more sensitive parameter for left ventricular damage than LVEF, but is less readily measured. A prospective large cohort should be analyzed to provide more conclusive results.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Gietema, Prof. Dr. J.A. Medische Oncologie UMCG and Steggink, Drs. L.C. arts-onderzoeker Medische Oncologie UMC and Medische Oncologie, Universitair Medisch Centrum Groningen |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:45 |
| Last Modified: | 25 Jun 2020 10:45 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/695 |
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