Evaluation of Right and Left Ventricular Systolic Functions in Breast Cancer Patients on Chemotherapy: A Transthoracic Echo Study

BACKGROUND: Cardio-toxicity is a major complication of chemotherapy for breast cancer women, and so evaluation of cardiac function   is important   to protect the heart from harmful drug toxic effects.OBJECTIVE:To assess and evaluate the cardio-toxic sequelae of chemotherapy used in the treatment of breast cancer on the left and right ventricular systolic functions by Transthoracic Echocardiography.PATIENTS AND METHODS: This is a cross-sectional study that was carried out in Baghdad Teaching Hospital in Baghdad .                   A sample of 60 women with breast cancer on chemotherapy combination: Endoxan (Cyclophosphamide) + Doxorubicin and Herceptin(Trastuzumab) + Taxol (Paclitaxel) and 30 healthy women without chemotherapy were enrolled in the study Specific echocardiographic parameters for right and left ventricular functions, in addition to hemodynamic measurements, were assessed by               the transthoracic echocardiography.RESULTS:  There were significant differences regarding left ventricular ejection fraction, which was significantly reduced in women receiving chemotherapy (P=0.003). Left ventricular systolic myocardial velocity showed significant reduction in women receiving chemotherapy (P=0.0001). The mitral annular plane systolic excursion was significantly reduced in women receiving chemotherapy (P=0.0002). A significant decline in the fractional area change of the right ventricle among chemotherapy women receivers, P=0.005. Also, the Tricuspid annular plane systolic excursion was statistically with significant reduction (P=0.0001).CONCLUSION:This study demonstrated that chemotherapy for Breast cancer causes a decrease in both left ventricular and right ventricular systolic functions.Moreover, the transthoracic echocardiographic study showed that the effect on left ventricle functions was more evident than on right ventricular functions.