Caroline O Fischer-Bacca, Ramon Huntermann, Juan Peres de Oliveira, Francisco B Alexandrino, Mariane Y Sato, Rhanderson Cardoso, Rodrigo F Gomes, Edielle S Melo
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引用次数: 0
Abstract
Introduction: Cancer therapy-induced cardiotoxicity (CTRCD) is a significant adverse effect of oncologic treatment, associated with considerable morbidity and mortality. Among CTRCD, heart failure stands out in prevalence and severity, with left ventricular dysfunction being the focus of most studies. Right ventricle (RV) may also be damaged by CTRCD, however the effects of CTRCD on RV function (RVF) have not been elucidated.
Objective: We aimed to conduct a systematic review and meta-analysis evaluating RV echocardiographic parameters in patients undergoing chemotherapy.
Methods: PubMed, Embase and Cochrane were searched for studies that evaluated RV parameters during cancer therapy. Statistical analysis was performed using the R statistical software. We computed pooled mean differences (MD), adopting a random-effects model, with a significance level of 0.05. A correlation coefficient of 0.5 was assumed for paired measurements. Heterogeneity was assessed using the I² statistic.
Results: We included 1,520 patients from 25 studies, 73% of whom were women and with a mean age of 51.1±16.5 years. RVF was significantly lower after CTRCD, with reduction in fractional area change (MD=-2.29% [95% CI: -3.63,-0.95]), RV global longitudinal strain (MD=2.49% [95% CI: 1.73, 3.25]), and RV free wall strain (MD=3.21% [95% CI: 2.32, 4.11]). Additionally, tricuspid annular plane systolic excursion was significantly reduced (MD=-1.44mm [95% CI: -1.94, -0.95]) and pulmonary artery systolic pressure was significantly higher (MD=1.60mmHg [95% CI: 0.64, 2.56]) after chemotherapy.
Conclusion: The assessment of RVF is important in CTRCD, and its quantification should be included in clinical follow-up during cancer treatment. Further research is needed to elucidate the underlying factors contributing to RV dysfunction and to develop methods for its early detection.
期刊介绍：
Under the editorial leadership of noted cardiologist Dr. Hector O. Ventura, Current Problems in Cardiology provides focused, comprehensive coverage of important clinical topics in cardiology. Each monthly issues, addresses a selected clinical problem or condition, including pathophysiology, invasive and noninvasive diagnosis, drug therapy, surgical management, and rehabilitation; or explores the clinical applications of a diagnostic modality or a particular category of drugs. Critical commentary from the distinguished editorial board accompanies each monograph, providing readers with additional insights. An extensive bibliography in each issue saves hours of library research.
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