Comportamiento del Strain ventrículo derecho en pacientes tratados con quimioterapia y/o radioterapia en una cohorte de pacientes
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Cardiology
oncology
radiation
ventricular function
echocardiography
cardiología
oncología
radiación
función ventricular
ecocardiografía
oncology
radiation
ventricular function
echocardiography
cardiología
oncología
radiación
función ventricular
ecocardiografía
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Volume Title
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Intituto Tecnológico de Santo Domingo (INTEC)
Introducción: es bien conocida la utilidad del strain global longitudinal (SGL) del ventrículo izquierdo (VI) en pacientes que reciben antineoplásicos. Estudios recientes sugieren una conducta similar del strain longitudinal de la pared libre (SLPL) del ventrículo derecho (VD), pero en la literatura aún existen muchas controversias que limitan su valoración, por lo que este estudio es un aporte a esta necesidad de practicidad.
Objetivo: evaluar el comportamiento del SLPL del VD en los pacientes tratados con quimioterapia y/o radioterapia, y su correlación con el SGL del VI.
Metodología: se aplicó un protocolo de recolección de datos que incluía variables demográficas y antecedentes de pacientes con diagnóstico de cáncer, tratados con quimioterapia y/o radioterapia, que acudieron a realizarse un ecocardiograma con strain, desde noviembre 2020 a marzo 2021. El ecocardiograma se hizo acorde con los estándares de las guías de la Sociedad Americana de Ecocardiografía, que incluyera SGL del VI y el SLPL del VD. Los datos fueron analizados en programa SPSS.
Resultados: de 90 pacientes, 6 excluidos para un total de 84 recopilados. 89 % mujeres, edad promedio 59 ±11 años, 73 % cáncer de mama. 54 % hipertensos, 27 % obesos, 23 % con dislipidemia, 19 % diabéticos y 11 % eran o fueron fumadores. 46 % había recibido quimioterapia y radioterapia concomitantes y el 48 % había recibido tratamiento hace más de un año. En hallazgos ecocardiográficos: fracción de eyección del VI (FE) promedio 64±7; sin embargo, 82 % tenía SGL del VI reducido (44 % menor a -15 %). De manera similar, el 74 % tenía reducción del SLPL del VD, pero solo el 15 % de la onda S del Doppler tisular del VD estaba anormal, 7 % del TAPSE estaba reducido y 6 % el cambio del área fraccional (CAF). El coeficiente de correlación de Pearson entre el SGL del VI y el SLPL del VD fue de 0.463, con un valor de p <.001, indicando una significativa relación lineal positiva moderada.
Conclusión: nuestro estudio sugiere que el SLPL del VD tiene un comportamiento similar al SGL del VI y es un mejor predictor de disfunción ventricular derecha, por encima de los parámetros convencionales. Por esta razón, debería incorporarse como una medida rutinaria en la evaluación ecocardiográfica de los pacientes que reciben terapias antineoplásicas.
Introduction: It is well known the usefulness of left ventricle (LV) longitudinal global strain (GLS) in patients receiving antineoplastic therapy. Recent studies suggested a similar behavior of the right ventricle (RV) free wall longitudinal strain (FWLS), but in the literature there are still many controversies that limit its evaluation, so this study is a contribution to this need for practicality. Objective: To assess the behavior and usefulness of RV FWLS in patients treated with chemotherapy and/or radiotherapy and its correlation with the LV GLS. Method: A data collection protocol that included demographic variables and personal history was applied to patients diagnosed with cancer treated with chemotherapy and/ or radiotherapy who underwent an echocardiogram with strain from November 2020 to March 2021. The echocardiogram was performed accordingly with American Society of Echocardiography guidelines standards, including a LV GLS and a RV FWLS. The data was analyzed in the SPSS program. Results: Of 90 patients, 6 excluded for a total of 84 collected. 89% were women, mean age 59 ±11 years, 73% breast cancer. 54% had hypertension, 27% obesity, 23% dyslipidemia, 19% were diabetic and 11% are or use to be smokers. 46% had received concomitantly chemotherapy and radiotherapy and 48% were treated more than a year ago. In echocardiographic findings, mean LV ejection fraction (EF) was 64±7 %, however, 82% had reduced LV GLS (44% being less than -15%). Similarly, 74% of RV FWLS was reduced, but only 15% of the S wave of the RV by tissue Doppler was abnormal, 7% of TAPSE was reduced, and 6% of fractional area change (FAC). The Pearson correlation coefficient between LV GLS and RV FWLS was of 0.463 with a p value of <.001 indicating a significant moderate positive linear relationship. Conclusion: Our study suggests that RV FWLS has a similar behavior as LV GLS and is a better predictor of right ventricular dysfunction over conventional parameters. Whereby should be incorporated as a routine measurement in the echocardiographic evaluation of patients receiving antineoplastic therapy.
Introduction: It is well known the usefulness of left ventricle (LV) longitudinal global strain (GLS) in patients receiving antineoplastic therapy. Recent studies suggested a similar behavior of the right ventricle (RV) free wall longitudinal strain (FWLS), but in the literature there are still many controversies that limit its evaluation, so this study is a contribution to this need for practicality. Objective: To assess the behavior and usefulness of RV FWLS in patients treated with chemotherapy and/or radiotherapy and its correlation with the LV GLS. Method: A data collection protocol that included demographic variables and personal history was applied to patients diagnosed with cancer treated with chemotherapy and/ or radiotherapy who underwent an echocardiogram with strain from November 2020 to March 2021. The echocardiogram was performed accordingly with American Society of Echocardiography guidelines standards, including a LV GLS and a RV FWLS. The data was analyzed in the SPSS program. Results: Of 90 patients, 6 excluded for a total of 84 collected. 89% were women, mean age 59 ±11 years, 73% breast cancer. 54% had hypertension, 27% obesity, 23% dyslipidemia, 19% were diabetic and 11% are or use to be smokers. 46% had received concomitantly chemotherapy and radiotherapy and 48% were treated more than a year ago. In echocardiographic findings, mean LV ejection fraction (EF) was 64±7 %, however, 82% had reduced LV GLS (44% being less than -15%). Similarly, 74% of RV FWLS was reduced, but only 15% of the S wave of the RV by tissue Doppler was abnormal, 7% of TAPSE was reduced, and 6% of fractional area change (FAC). The Pearson correlation coefficient between LV GLS and RV FWLS was of 0.463 with a p value of <.001 indicating a significant moderate positive linear relationship. Conclusion: Our study suggests that RV FWLS has a similar behavior as LV GLS and is a better predictor of right ventricular dysfunction over conventional parameters. Whereby should be incorporated as a routine measurement in the echocardiographic evaluation of patients receiving antineoplastic therapy.
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info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
info:eu-repo/semantics/publishedVersion
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Science and Health; Vol. 7 No. 1 (2023): Science and Health, january-march; 75-84
Ciencia y Salud; Vol. 7 Núm. 1 (2023): Ciencia y Salud, enero-marzo; 75-84
2613-8824
2613-8816
10.22206/cysa.2023.v7i1
Ciencia y Salud; Vol. 7 Núm. 1 (2023): Ciencia y Salud, enero-marzo; 75-84
2613-8824
2613-8816
10.22206/cysa.2023.v7i1