Echocardiographic Evaluation of the Right Ventricle Function After Chemotherapy With Anthracyclines

Abstract

Chemotherapy regimens containing anthracyclines are widely used in the treatment of malignancies such as lymphoma and breast cancer. While these regimens are effective, they are associated with adverse effects, with cardiac complications being the most significant. These dose-dependent complications can involve both right and left ventricular dysfunction, are often irreversible, and can have serious consequences for the patient. Given the widespread use of this treatment regimen and its important cardiac side effects, patients undergoing treatment require monitoring for these complications to enable prompt intervention if adverse events occur. Most studies focusing on cardiotoxicity related to chemotherapy have primarily examined left ventricular function, with limited investigation into right ventricular function. However, right-sided heart failure can potentially occur in patients undergoing anthracycline treatment, making this study essential in providing valuable and noteworthy information in this regard. Materials and Methods: In this cohort study, all patients receiving anthracycline-based chemotherapy for various types of cancer were selected. They underwent echocardiography before initiating treatment, 15 days after the second session of chemotherapy, and 15 days after completing the final session of treatment. The occurrence of cardiotoxicity was also calculated. The pre- and post-treatment findings regarding right and left ventricular involvement were compared between individuals with and without cardiotoxicity. To maintain study consistency due to variable treatment doses of anthracycline regimens, the study focused specifically on breast cancer patients. Results: The measured value of RV free Wall Strain remained relatively constant 15 days after completing the second session of treatment compared to before treatment, but it showed a statistically significant decrease 15 days after completing the final session of treatment (p = 0.044). The number of patients with abnormal RV free Wall Strain before treatment and 15 days after completing the second session was ten. However, this number increased to 22 patients at 15 days after completing the final session of treatment, indicating a considerable increase in patients with abnormal RV free Wall Strain on echocardiography (p = 0.037).