Acute Radiation Effects on Cardiac Function Detected by Strain Rate Imaging in Breast Cancer Patients
- Department of Radiotherapy, University Hospital Gasthuisberg, Leuven (Belgium)
- Department of Cardiology, Institute of Emergency for Cardiovascular Diseases, UMF Carol Davila, Bucharest (Romania)
- Department of Cardiology, University Hospital Gasthuisberg, Leuven (Belgium)
- Department of Medical Oncology, University Hospital Gasthuisberg, Leuven (Belgium)
Purpose: To investigate the occurrence of early radiation-induced changes in regional cardiac function using strain rate imaging (SRI) by tissue Doppler echocardiography. Methods and Materials: We included 20 left-sided and 10 right-sided breast cancer patients receiving radiotherapy (RT) to the breast or chest wall. Standard echocardiography and SRI were performed before RT (baseline), immediately after RT (post-RT), and at 2 months follow-up (FUP) after RT. Regional strain (S) and strain rate (SR) values were obtained from all 18 left ventricular (LV) segments. Data were compared to the regional radiation dose. Results: A reduction in S was observed post-RT and at FUP in left-sided patients (S{sub post-RT}: -17.6 {+-} 1.5%, and S{sub FUP}: -17.4 {+-} 2.3%, vs. S{sub baseline}: -19.5 {+-} 2.1%, p < 0.001) but not in right-sided patients. Within the left-sided patient group, S and SR were significantly reduced after RT in apical LV segments (S{sub post-RT}: -15.3 {+-} 2.5%, and S{sub FUP}: -14.3 {+-} 3.7%, vs. S{sub baseline}: -19.3 {+-} 3.0%, p < 0.01; and SR{sub post-RT}: -1.06 {+-} 0.15 s {sup -1}, and SR{sub FUP}: -1.16 {+-} 0.28 s {sup -1}, vs. SR{sub baseline}: -1.29 {+-} 0.27s {sup -1}, p = 0.01), but not in mid- or basal segments. Furthermore, we observed that segments exposed to more than 3 Gy showed a significant decrease in S after RT (S{sub post-RT}: -16.1 {+-} 1.6%, and S{sub FUP}: -15.8 {+-} 3.4%, vs. S{sub baseline}: -18.9 {+-} 2.6%, p < 0.001). This could not be observed in segments receiving less than 3 Gy. Conclusions: SRI shows a dose-related regional decrease in myocardial function after RT. It might be a useful tool in the evaluation of modern RT techniques, with respect to cardiac toxicity.
- OSTI ID:
- 21491682
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 5 Vol. 79; ISSN IOBPD3; ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
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Related Subjects
BIOLOGICAL EFFECTS
BIOLOGICAL RADIATION EFFECTS
BODY
CARDIOVASCULAR SYSTEM
CHEST
DISEASES
EARLY RADIATION EFFECTS
FUNCTIONS
GLANDS
HEART
MAMMARY GLANDS
MEDICINE
MUSCLES
MYOCARDIUM
NEOPLASMS
NUCLEAR MEDICINE
ORGANS
RADIATION EFFECTS
RADIOLOGY
RADIOTHERAPY
STRAIN RATE
THERAPY
WALLS