Subclinical ventricular dysfunction detected by speckle tracking two years after use of anthracycline
| العنوان: | Subclinical ventricular dysfunction detected by speckle tracking two years after use of anthracycline |
|---|---|
| المؤلفون: | Alberto Teófilo de Souza Filho, Daniel de Castro Araújo Cunha, Edval Gomes dos Santos Júnior, Viviane Almeida Silva, João Ricardo Pinto Lopes, Danilo Leal Miranda, Murilo Oliveira da Cunha Mendes, Vinícius Guedes Rios, Samuel Oliveira de Afonseca, André Luiz Cerqueira de Almeida |
| المصدر: | Arquivos Brasileiros de Cardiologia, Vol 104, Iss 4, Pp 274-283 (2015) Arquivos Brasileiros de Cardiologia v.104 n.4 2015 Arquivos Brasileiros de Cardiologia Sociedade Brasileira de Cardiologia (SBC) instacron:SBC Arquivos Brasileiros de Cardiologia, Volume: 104, Issue: 4, Pages: 274-283, Published: 27 JAN 2015 |
| سنة النشر: | 2014 |
| مصطلحات موضوعية: | Adult, medicine.medical_specialty, lcsh:Diseases of the circulatory (Cardiovascular) system, Anthracycline, Insuficiência Cardíaca, Doppler echocardiography, Ventricular Function, Left, Antraciclinas / efeitos adversos, Ventricular Dysfunction, Left, Internal medicine, Neoplasms, Ventricular Dysfunction Left / chemically induced, medicine, polycyclic compounds, Disfunção Ventricular Esquerda / induzido quimicamente, Humans, Arterial Pressure, Anthracyclines / adverse effects, Subclinical infection, Aged, Heart Failure, Ejection fraction, Antibiotics, Antineoplastic, medicine.diagnostic_test, business.industry, Case-control study, Age Factors, Reproducibility of Results, Stroke Volume, Original Articles, Stroke volume, Middle Aged, medicine.disease, Echocardiography, Doppler, Surgery, Blood pressure, Cross-Sectional Studies, Echocardiography, lcsh:RC666-701, Doxorubicin, Heart failure, Case-Control Studies, Cardiology, Linear Models, Female, Cardiology and Cardiovascular Medicine, business, Ecocardiografia |
| الوصف: | Background: Heart failure is a severe complication associated with doxorubicin (DOX) use. Strain, assessed by two-dimensional speckle tracking (2D-STE), has been shown to be useful in identifying subclinical ventricular dysfunction. Objectives: a) To investigate the role of strain in the identification of subclinical ventricular dysfunction in patients who used DOX; b) to investigate determinants of strain response in these patients. Methods: Cross-sectional study with 81 participants: 40 patients who used DOX ±2 years before the study and 41 controls. All participants had left ventricular ejection fraction (LVEF) ≥55%. Total dose of DOX was 396mg (242mg/ms2). The systolic function of the LV was evaluated by LVEF (Simpson), as well as by longitudinal (εLL), circumferential (εCC), and radial (εRR) strains. Multivariate linear regression (MLR) analysis was performed using εLL (model 1) and εCC (model 2) as dependent variables. Results: Systolic and diastolic blood pressure values were higher in the control group (p < 0.05). εLL was lower in the DOX group (-12.4 ±2.6%) versus controls (-13.4 ± 1.7%; p = 0.044). The same occurred with εCC: -12.1 ± 2.7% (DOX) versus -16.7 ± 3.6% (controls; p < 0.001). The S’ wave was shorter in the DOX group (p = 0.035). On MLR, DOX was an independent predictor of reduced εCC (B = -4.429, p < 0.001). DOX (B = -1.289, p = 0.012) and age (B = -0.057, p = 0.029) were independent markers of reduced εLL. Conclusion: a) εLL, εCC and the S’ wave are reduced in patients who used DOX ±2 years prior to the study despite normal LVEF, suggesting the presence of subclinical ventricular dysfunction; b) DOX was an independent predictor of reduced εCC; c) prior use of DOX and age were independent markers of reduced εLL. Fundamento: A insuficiência cardíaca é uma complicação grave associada ao uso da doxorrubicina (DOX). O strain, avaliado por speckle tracking bidimensional (2D-STE), tem se mostrado útil na identificação de disfunção ventricular subclínica. Objetivos: a) Investigar o comportamento do strain na identificação de disfunção ventricular subclínica em pacientes que usaram DOX; b) investigar determinantes do comportamento do strain nestes pacientes. Métodos: Estudo transversal com 81 participantes: 40 pacientes que usaram DOX ± 2 anos antes do estudo e 41 controles. Todos tinham fração de ejeção do ventrículo esquerdo (FEVE) ≥ 55%. A dose total de DOX foi de 396 mg (242 mg/m2). A função sistólica do VE foi avaliada pela FEVE (Simpson), assim como pelo strain longitudinal (εLL), circunferencial (εCC) e radial (εRR). Realizamos análise de regressão linear multivariada (RLM) usando como variáveis dependentes o εLL (modelo 1) e o εCC (modelo 2). Resultados: Os valores da pressão arterial sistólica e diastólica foram maiores no grupo controle (p < 0,05). O εLL foi menor no grupo DOX (-12,4 ± 2,6%) versus controle (-13,4 ± 1,7%; p = 0,044). O mesmo ocorreu em relação ao εCC: -12,1 ± 2,7% (DOX) versus -16,7 ± 3,6% (controles; p < 0,001). A onda S' foi menor no grupo DOX (p = 0,035). Na RLM, a DOX foi preditora independente de redução do εCC (B = -4,429, p < 0,001). DOX (B = -1,289, p = 0,012) e idade (B = -0,057, p = 0,029) foram marcadores independentes de redução do εLL. Conclusões: a) O εLL, o εCC e a onda S' estão reduzidos nos pacientes que usaram DOX ±2 anos antes do estudo, apesar da FEVE ser normal, sugerindo presença de disfunção ventricular subclínica; b) a DOX foi preditora independente de redução do εCC; c) o uso prévio da DOX e a idade foram marcadores independentes de redução do εLL. |
| وصف الملف: | text/html |
| تدمد: | 1678-4170 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::09d46712ecbb7e3bf06cc26e29cd6251Test https://pubmed.ncbi.nlm.nih.gov/26594722Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....09d46712ecbb7e3bf06cc26e29cd6251 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 16784170 |
|---|