Early effects of adjuvant breast cancer radiotherapy on right ventricular systolic and diastolic function

Suvi Sirkku Tuohinen; Tanja Skyttä; Vesa Virtanen; Tiina Luukkaala; Pirkko-Liisa Kellokumpu-Lehtinen; Pekka Raatikainen

Early effects of adjuvant breast cancer radiotherapy on right ventricular systolic and diastolic function

Anticancer Res. 2015 Apr;35(4):2141-7.

Authors

Suvi Sirkku Tuohinen¹, Tanja Skyttä², Vesa Virtanen³, Tiina Luukkaala⁴, Pirkko-Liisa Kellokumpu-Lehtinen², Pekka Raatikainen⁵

Affiliations

¹ Heart Center Co., Tampere University Hospital and School of Medicine, University of Tampere, Tampere, Finland suvi.tuohinen@sydansairaala.fi.
² Department of Oncology, Tampere University Hospital and School of Medicine, University of Tampere, Tampere, Finland.
³ Heart Center Co., Tampere University Hospital and School of Medicine, University of Tampere, Tampere, Finland.
⁴ Science Center Pirkanmaa Hospital District and School of Health Sciences, University of Tampere, Tampere, Finland.
⁵ Department of Medicine, Central Finland Health Care District and University of Eastern Finland, Jyväskylä, Finland.

PMID: 25862870

Abstract

Aim: Reduced right ventricular (RV) systolic function correlates with poor prognosis in several heart diseases. The aim of this prospective single-Center study was to investigate whether conformal three-dimensional (3D) breast cancer radiotherapy impairs RV function.

Patients and methods: Forty-nine patients with early-stage left-sided breast cancer underwent comprehensive two-dimensional (2D) echocardiography before and after radiotherapy. RV function was evaluated with tricuspid annular plane systolic excursion (TAPSE), pulsed tissue Doppler peak velocity at the lateral RV wall (S') and RV and venous flow analysis.

Results: Radiotherapy reduced TAPSE from 24.5 ± 4.0 mm to 22.4 ± 3.9 mm (p<0.001), S' from 12.7 ± 3.1 m/s to 12.2 ± 2.7 m/s (p=0.11) and pulmonary flow velocity time integral (VTI) from 16.6 ± 3.1 cm to 15.9 ± 2.3 cm (p=0.07), respectively. These changes were unrelated to changes in LV function.

Conclusion: Modern radiotherapy reduced RV systolic function. As a readily-available and sensitive measurement, TAPSE is as a practical tool for detection of radiotherapy-induced cardiac changes.

Keywords: Radiotherapy; TAPSE; breast cancer; right ventricle.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Breast Neoplasms / drug therapy*
Breast Neoplasms / pathology
Breast Neoplasms / radiotherapy*
Echocardiography, Doppler
Female
Humans
Middle Aged
Prognosis*
Radiation Dosage
Radiotherapy, Adjuvant / methods
Tricuspid Valve / pathology
Ventricular Function, Right