Efficacy of Echocardiographic Parameters in Predicting Chemoradiotherapy-Induced Cardiotoxicity in Patients With Breast Cancer

Document Type : Original Article


1 Department of Medical Physics, School of Medicine, Iran University of Medical Sciences, Tehran, IR Iran.

2 Echocardiography Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.

3 Cardio-Oncology Department and Research Center, Rajaie Cardiovascular Medical and Research Center, Tehran, IR Iran.

4 Department of Radiation Oncology, School of Medicine, Imam Hossein Hospital, Shahid Beheshti University of Medical Science, Tehran, IR Iran.

5 Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.

6 Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, IR Iran.


Objective: Using echocardiographic parameters, we sought to predict cardiotoxicity in patients with breast cancer before treatment.
Methods: The study recruited 53 left-sided breast cancer patients with no previous history of heart failure or cancer treatment. The patients underwent 2D and 3D echocardiography before and 6 months after the end of treatment. The main criterion for cardiotoxicity was a reduction in posttreatment LVEF exceeding 10% compared with pretreatment. Systolic and diastolic parameters were compared between 2 groups: complicated and noncomplicated. Binary logistic regression was used to predict cardiotoxicity.
Results: The patients’ mean age was 49 ± 11.2 years. No statistical differences existed between the groups in demographics and cardiac risk factors at study commencement. Posttreatment, 4 echocardiographic parameters (E/A ratio, sPAP, LVEF, and LVGLS) were significantly changed compared with pretreatment echocardiography. The regression analysis showed that E/A ratio was effective in predicting cardiotoxicity (sensitivity = 68%, specificity = 76%, AUC =77%; and P <0.001).
Conclusions: Echocardiography, aside from its usefulness in diagnosing cardiotoxicity, can be valuable in predicting complications, especially in patients with breast cancer at higher risk of cardiotoxicity due to chemotherapy and radiotherapy in the chest wall area. (Iranian Heart Journal 2023; 24(3): 62-69)


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