Assessment of Incidence and Severity of Cardio Toxicity of Chemotherapeutic Drugs and Methods for its Early Identification
Arulanandhan Ettiyan*Dr Mgr Medical University, Tamilnadu, India.Citation: Ettiyan A (2024) Assessment of Incidence and Severity of Cardio Toxicity of Chemotherapeutic Drugs and Methods for its Early Identification. SciTech Women & Nursing 2024.
Received: August 28, 2024 Accepted: August 29, 2024 Published: August 29, 2024
Abstract
Introduction: Chemotherapy using anthracyclines and also other drugs lead to varied expression of reversible or permanent cardiovascular damage which every physician treating cancer patients must know.
Such cardiovascular effects are a result of : Possible toxicity of chemotherapeutic agent. Possible risk factors or pre-existing cardiovascular disease, predisposing to the development of cardiotoxicity.
Aim of the study:
- To identify incidence and onset of systolic / diastolic dysfunction during chemotherapy and postulate methods for its early identification and possible modification of its course.
Methods used:
- All patients enrolled underwent 2D echocardiography performed by an experienced cardiologist and it was cross checked by another cardiologist, both were double blinded. Echocardiography was performed at four stages
- Before starting chemotherapy (base time – T1)
- On the day after completion of 2nd cycle chemotherapy (T2)
- Post 4th cycle treatment (T3)
- 6 months after the post treatment (T4)
- Biomarkers: Troponin I & BNP levels screening were done after completion of 2nd cycle of chemotherapy.
Result
- 56% (27/48)of patients on Adriamycin developed diastolic dysfunction.
- 10% (5/48) of patients on Adriamycin developed fall in ejection fraction.
- Similarly, 10% (5/48) of patients on Adriamycin developed RV dysfunction.
- Diastolic dysfunction with Adriamycin was noted mostly after the 2nd cycle (cumulative dose of 200mg). Systolic dysfunction was seen after 4th cycle (total cumulative dose of 400 mg).
- LV systolic dysfunction: Usually seen after completion of chemotherapy (T4 stage).
- LV diastolic dysfunction: Starts usually after 2nd cycle of CT and remains impaired until after the completion of cycles & upto 6 months after the therapy. 87% of patients who developed LV dysfunction were found to be on ACP regimen
Conclusion:
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The cardiotoxicity was dose-dependant with diastolic dysfunction being noted after a cumulative dose of 200 mg of Adriamycin & systolic dysfunction after a cumulative dose of 400 mg.
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LV dysfunction induced by Adriamycin based chemotherapy improved after stoppage or change of regimen.
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GDMT (Guideline directed medical therapy) for heart failure also plays a major part in treating such patients
