Table 1. Baseline clinical characteristics of the study population (n=25).
Age, years
|
52.1 ± 13.1
|
Weight, kg
|
74.3 ± 14.8
|
Height, cm
|
157 ± 5.9
|
BMI, kg/m²
|
29.9 ± 6.0
|
SBP, mmHg
|
130.2 ± 18.7
|
DBP, mmHg
|
82.2 ± 12.6
|
Heart rate, bpm
|
84.0 ± 11.0
|
eGFR, mL/min/1.73 m²
|
102.4 (81.9-129.1)
|
Hypertension
|
8 (32%)
|
Type 2 diabetes
|
3 (12%)
|
Smoking
|
13 (52%)
|
Obesity (BMI>30Kg/m²)
|
12 (48%)
|
Radiotherapy
|
21 (84%)
|
Anthracyclines
|
11 (46%)
|
Angiotensin-converting enzyme inhibitor
|
5 (20%)
|
Beta-blockers
|
5 (20%)
|
** Values noted as mean ± SD, median (IQR) or N (%).
BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; eGRF, estimated glomerular filtration rate.
Table 2. Mean values of echocardiographic parameters of the baseline and follow-up.
|
Exam 1
|
Exam 2
|
Exam 3
|
Exam 4
|
LVEF, %
|
64.1 ± 4.9
|
61.6 ± 6.6
|
62.3 ± 6.7
|
60.9 ± 4.9*
|
LV GLS, %
|
-20.6 ± 2.0
|
-19.4 ± 2.1*
|
-19.2 ± 1.8*
|
-19.0 ± 2.1*
|
RV basal, mm
|
34.4 ± 4.1
|
35.1 ± 3.7
|
34.9 ± 3.0
|
34.6 ± 3.0
|
TAPSE, mm
|
21.9 ± 3.0
|
20.2 ± 2.3
|
20.8 ± 3.4
|
21.5 ± 3.8
|
S´ wave, cm/s
|
13.1 ± 1.2
|
12.7 ± 2.0
|
12.6 ± 2.0
|
12.5 ± 2.1
|
RV FAC (%)
|
44.3 ± 6.6
|
42.9 ± 5.7
|
39.9 ± 6.0*
|
42.1 ± 6.2
|
RV GLS (%)
|
-23.9 ± 1.6
|
-22.5 ± 2.1*
|
-22.5 ± 2.3*
|
-23.1 ± 2.2
|
FW GLS (%)
|
-26.6 ± 2.5
|
-25.9 ± 3.0
|
-24.7 ± 3.8
|
-26.1 ± 3.5
|
Data are presented as the mean + SD.
*p < 0.05 compared to Exam 1 (baseline).
Exam 1 baseline echocardiogram; Exam 2 echocardiogram performed between 3 and 6 months; Exam 3 echocardiogram performed between 6 and 9 months; Exam 4 echocardiogram performed between 9 and 12 months.
LVEF, left ventricular ejection fraction; LV GLS, left ventricular global longitudinal strain; RV, right ventricular; FAC: Fractional Area Change, TAPSE, tricuspid annular plane systolic excursion; S´ wave, tricuspid annular peak systolic velocity; RV GLS, right ventricular global longitudinal strain; FW GLS, right ventricular free wall global longitudinal strain.
Table 3. Clinical characteristics in patients with and without subclinical LV cardiotoxicity.
Variable
|
No LV subclinical cardiotoxicity
n=12
|
LV subclinical cardiotoxicity
n=13
|
P-value
|
|
Age, years
|
50.8 ± 10.1
|
53.4 ± 15.8
|
0.633
|
|
|
Weight, kg
|
72.4 ± 8.0
|
76.1 ± 19.2
|
0.533
|
|
Height, cm
|
155 ± 5.1
|
159 ± 6.8
|
0.097
|
|
BMI, kg/m²
|
30.0 ± 3.9
|
29.8 ± 7.6
|
0.943
|
|
SBP, mmHg
|
132.4 ± 20.7
|
128.3 ± 17.5
|
0.613
|
|
DBP, mmHg
|
85.9 ± 12.7
|
79.1 ± 12.2
|
0.194
|
|
Heart rate, bpm
|
76.5 ± 12.2
|
74.9 ± 11.5
|
0.750
|
|
eGFR, mL/min/1.73 m²
|
105.1 ± 35.4
|
118.3 ± 56.8
|
0.491
|
|
Hypertension
|
4 (33%)
|
4 (31%)
|
0.891
|
|
Type 2 diabetes
|
1 (8%)
|
2 (15%)
|
0.588
|
|
Obesity
|
7 (58%)
|
5 (38%)
|
0.320
|
|
Smoking
|
7 (58%)
|
6 (46%)
|
0.543
|
|
ACEI/ARB
|
2 (17%)
|
3 (23%)
|
0.689
|
|
Beta-blockers
|
3 (25%)
|
2 (15%)
|
0.548
|
|
Radiotherapy
|
11 (92%)
|
10 (77%)
|
0.315
|
Anthracyclines use
|
5 (42%)
|
6 (46%)
|
0.682
|
|
|
|
|
|
|
|
|
|
|
** Values noted as mean ± SD or N (%).
BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure
eGRF, estimated glomerular filtration rate; ACEI/ARB, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers.
Table 4. Echocardiographic baseline parameters in patients with subclinical cardiotoxicity and without subclinical cardiotoxicity
Variable
|
No LV subclinical cardiotoxicity
n=12
|
LV subclinical cardiotoxicity
n=13
|
P-value
|
|
LV diastolic diameter, cm
|
45.3 ± 2.7
|
50.5 ± 3.2
|
0.0002
|
LV systolic diameter, cm
|
29.5 ± 2.5
|
32.7 ± 4.1
|
0.027
|
|
Septal wall thicknesses, cm
|
8.0 ± 0.7
|
8.5 ± 1.0
|
0.214
|
|
Posterior wall thicknesses, cm
|
7.7 ± 0.5
|
8.1 ± 1.0
|
0.188
|
|
LV Diastolic Volume, mL
|
86.6 ± 16.6
|
112.0 ± 31.7
|
0.02
|
|
LV Systolic Volume, mL
|
37.6 ± 12.1
|
49.6 ± 15.2
|
0.039
|
|
LVEF, %
|
64.2 ± 4.4
|
64.0 ± 5.5
|
0.934
|
|
LA diameter, cm
|
34.8 ± 3.9
|
36.9 ± 4.7
|
0.222
|
|
LA volume, mL
|
52.1 ± 11.2
|
62.5 ± 22.9
|
0.191
|
|
E/e´ mean
|
8.4 ± 2.1
|
7.9 ± 2.9
|
0.666
|
|
Transtricuspid gradient, mmHg
|
23.2 ± 7.9
|
24.9 ± 4.6
|
0.723
|
|
RV basal, mm
|
34.3 ± 3.7
|
34.5 ± 4.5
|
0.938
|
|
TAPSE, mm
|
21.7 ± 2.6
|
22.1 ± 3.5
|
0.771
|
|
S´ wave, cm/s
|
13.6 ± 0.9
|
12.7 ± 1.3
|
0.116
|
|
RV FAC, %
|
44.7 ± 6.9
|
43.9 ± 6.5
|
0.79
|
|
RV GLS, %
|
-23.8 ± 1.8
|
-24.1 ± 1.4
|
0.662
|
|
FW GLS, %
|
-26.4 ± 2.8
|
-26.8 ± 2.3
|
0.740
|
|
|
|
|
|
|
|
|
|
|
Data are presented as the mean + SD.
LVEF, left ventricular ejection fraction; LA: left atrial; RV, right ventricular; FAC: Fractional Area Change, TAPSE, tricuspid annular plane systolic excursion; S´ wave, tricuspid annular peak systolic velocity; RV GLS, right ventricular global longitudinal strain; FW GLS, right ventricular free wall global longitudinal strain.