Evaluation of subclinical cardiotoxicity in patients with breast cancer and arterial hypertension in two regimens of anthracycline-containing chemotherapy

Objective. To study of subclinical cardiotoxicity of two anthracycline-containing chemotherapy regimens in breast cancer patients with normotension and arterial hypertension. Materials and methods. 119 women (mean age 48,8±10,9 years) with triple negative breast cancer were enrolled. They are received one of two chemotherapy options that differed in the intensity and duration of treatment, including the total dose of anthracyclines. Depending on the chemotherapy option, the patients were divided into two groups: group 1 (n=54) - treatment duration ≤8 weeks, cumulative dose of doxorubicin was 200 mg/m2, group 2 (n=65) - treatment duration ≤16 weeks, the cumulative dose of doxorubicin was 320 mg/m2. Before and after chemotherapy completion of all patients, the level of troponin T (h.s.) and NT-proBNP was determined, and heart ultrasound was performed, 2D and 3D speckle tracking imaging. Results. In patients who received a higher cumulative dose of doxorubicin (group 2), a statistically significant increase in biomarkers of myocardial damage was observed (h.s. troponin T before chemotherapy was 7.8±0.5 pg/ml, after chemotherapy - 55.0±7.0 pg/ml, p<0.05; NT-proBNP before chemotherapy was 88.6±10.7 pg/ml, after chemotherapy - 359.2±57.9 pg/ml, p<0.05) and a decrease in GLS according 2D speckle tracking imaging (from -20.4±0,4 to -16.8±0.4%, p<0.05) and GLS according 3D speckle tracking imaging (from -11.6±0.5 to -7.8±0.5%, p<0.05 ) and GAS according 3D speckle tracking imaging mode data (from -19.7±0.7 to -14.5±0.8%, p<0.05). The most pronounced changes were observed in patients with arterial hypertension. Conclusions. Increased risk of subclinical cardiotoxicity was associated with a higher cumulative dose of doxorubicin (320 mg/m2), as well as in patients with breast cancer with arterial hypertension

cardiooncology, arterial hypertension, cardiotoxicity, 2D и 3D Speckle Tracking Imaging, chemotherapy, breast cancer

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