Method of preventing cardiotoxic effect of anthracycline-containing regimens of chemotherapy for breast cancer - ICI Meeting 2016, 4-6 December, 2016, David Intercontinental Hotel, Tel Aviv, Israel

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¹Department of Cardiology and Internal Diseases, Belarusian State Medical University, Belarus
²Department of cancer mammology with cancer gynaecological group, N.N. Alexandrov National Cancer Centre of Belarus, Belarus
³Oncology department (genetics), N.N. Alexandrov National Cancer Centre of Belarus, Belarus

ABSTRACT

In the Republic of Belarus cancer and cardiovascular disease are the leading causes of disability and mortality. Anthracyclines have a high efficacy for the treatment of breast cancer. However, these drugs can also induce progressive cardiac remodelling as a late consequence of earlier myocyte damage, resulting in late cardiomyopathy.

PATIENTS AND METHODS

50 patients were randomized into 3 groups: group 1- with chemotherapy alone (30 cases), group 2 –patients with chemotherapy who received carvedilol combined with valsartan and had no hypertension (12 cases); group 3- patients with chemotherapy who received carvedilol combined with valsartan and had hypertension (8 cases).

RESULTS

After a full course of chemotherapy transmitral flow ratio significantly decreased in group 1 (p<0,05), which indicates deterioration of left ventricular diastolic function. Group 1 also showed a significant increase in the sphericity index systole and diastole (p<0,05), indicating the left ventricle remodeling during chemotherapy. These changes were not revealed in groups 2 and 3. The left ventricular ejection fraction was not significantly changed in all groups.

CONCLUSIONS

The earliest changes in the structural and functional parameters of the left ventricle as a result of chemotherapy are diastolic dysfunction and increased sphericity index. The use of valsartan in combination with carvedilol can reduce acute and chronic cardiotoxicity of breast cancer chemotherapy.