ECHOCARDIOGRAPHIC VENTRICULAR DIASTOLIC FUNCTION FOR EVALUATION OF CHEMOTHERAPY-INDUCED CARDIOTOXICITY

Background: The cardiotoxic effects of many chemotherapeutics are well reported. These effects vary from mild changes to serious complications. Tissue Doppler echocardiography was proposed as a useful diagnostic tool in patients affected by these changes. Aim of work: The present study aimed to evaluate left & right ventricles diastolic indices in patients on chemotheraputic treatment with doxorubicin and correlation of this parameters with some clinical, electrocardiographic and laboratory findings. Patients and Methods: The present prospective study included 75 patients scheduled to receive doxorubicin therapy for different indications. They were subjected to careful history taking, thorough clinical examination, laboratory investigations and assessment of cardiac functions using ECG, PW Doppler and tissue Doppler before receiving chemotherapy and in two occasions after starting treatment (after the second cycle and the end of the treatment). Results:In the current study, comparison between the studied patients and controls regarding the conventional echocardiographic parameters didn't show statistically significant differences. Prolonged QT is the most encountered ECG abnormality in the studied patients. Other changes included arrhythmia, low QRS, depressed ST, flattened and inverted T. Moreover, we found significant deterioration of diastolic dysfunction over the study period either using Doppler or tissue Doppler. In our study, patients with diastolic dysfunction were found to be older than patients without. However, the difference is not statistically significant. Regarding systolic dysfunction, the present study found systolic dysfunction in 4 patients (5.3 %). Conclusions: Diastolic dysfunction is prevalent among patients under chemotherapy treatment. TDI provides a useful tool for early detection.