Atrial Function in Patients with Breast Cancer After Treatment with Anthracyclines

作者：Yaylali Yalin Tolga^*; Saricopur Ahmet; Yurtdas Mustafa; Senol Hande; Gokoz Dogu Gamze

来源：Arquivos Brasileiros de Cardiologia, 2016, 107(5): 411-419.

DOI：10.5935/abc.20160146

• Atrial Function
• Arrhythmias, Cardiac
• Unilateral Breast Neoplasms
• Antrhacyclines
• Drug Therapy
• Cardiotoxicity

Background: Atrial electromechanical delay (EMD) is used to predict atrial fibrillation, measured by echocardiography.
Objectives: The aim of this study was to assess atrial EMD and mechanical function after anthracycline-containing chemotherapy.
Methods: Fifty-three patients with breast cancer (48 +/- 8 years old) who received 240 mg/m(2)of Adriamycin, 2400 mg/m(2) of cyclophosphamide, and 960 mg/m2 of paclitaxel were included in this retrospective study, as were 42 healthy subjects (47 +/- 9 years old). Echocardiographic measurements were performed 11 +/- 7 months (median 9 months) after treatment with anthracyclines.
Results: Left intra-atrial EMD (11.4 +/- 6.0 vs. 8.1 +/- 4.9, p = 0.008) and inter-atrial EMD (19.7 +/- 7.4 vs. 14.7 +/- 6.5, p = 0.001) were prolonged; LA passive emptying volume and fraction were decreased (p = 0.0001 and p = 0.0001); LA active emptying volume and fraction were increased (p = 0.0001 and p = 0.0001); Mitral A velocity (0.8 +/- 0.2 vs. 0.6 +/- 0.2, p = 0.0001) and mitral E-wave deceleration time (201.2 +/- 35.6 vs. 163.7 +/- 21.8, p = 0.0001) were increased; Mitral E/A ratio (1.0 +/- 0.3 vs. 1.3 +/- 0.3, p = 0.0001) and mitral Em (0.09 +/- 0.03 vs. 0.11 +/- 0.03, p = 0.001) were decreased; Mitral Am (0.11 +/- 0.02 vs. 0.09 +/- 0.02, p = 0.0001) and mitral E/Em ratio (8.8 +/- 3.2 vs. 7.6 +/- 2.6, p = 0.017) were increased in the patients.
Conclusions: In patients with breast cancer after anthracycline therapy: Left intra-atrial, inter-atrial electromechanical intervals were prolonged. Diastolic function was impaired. Impaired left ventricular relaxation and left atrial electrical conduction could be contributing to the development of atrial arrhythmias.

• 出版日期2016-11