Predictive power of repolaristaion parameters of electrocardiography for cardiotoxicity in breast cancer patients after chemotheraphy

Background: Breast cancer is the most common malignancy in women. The most common side effect related to chemotherapeutics in patients receiving cancer treatment is on cardiovascular system. In the treatment of breast cancer, anthracyclines are frequently preferred and may cause irreversible cardiotoxicity. There is no proven algorithm to identify patients at risk of developing cardiotoxicity in the early post-treatment period and after treatment. In current guidelines, strain ECO follow-up is recommended, but no method has been found to give a better idea of the time to development of mechanical dysfunction. In this study, we aimed to evaluate the QT and QTc dispersion, Tp-Te interval and Tp-Te / QT which are the repolarization evaluation parameters in ECG recordings. Methods: 35 patients (35 females, mean age 48.9 ± 11.8 years, mean doxorubicin cumulative dose 415 ± 32 mg / m2) who received chemotherapy due to breast cancer were retrospectively evaluated. preoperative and 3rd month 2-day strain ECOs were compared. QT and QTc, QT and QTc dispersion, QT, QTc and Tp-Te measurements were performed according to QT / QRR in ECG recordings. In the ECO recordings, GLS, circumferential strain, radial strain and torsion were evaluated. Results: It was observed that QT, QT dispersion and Tp-Te parameters were prolonged in the acute period after the treatment and this prolongation continued to decrease in the 3rd month. (statistically significant) için p<0,001; p<0,001; p<0,001). There was no significant change in GLS values in ECOs before and after treatment. (GLS avg: -0,21 ± 7,19 p = 0,863; GLS LAX avg: -1,32 ± 5,34 p = 0,153; GLS A4C avg: -0,47 ± 5,26 p = 0,603; avg: -1,71 ± 5,47 p = 0,072) But there was a significant decrease in circumferential strain, radial strain and torsion. (Circumferential strain -17,2 ± 3,53 to -13 ± 2,84 p <0,001, Radial strain 45,1 ± 8,32% 35,6 ± 10 p <0,001, torsion 12,1 ± 3.54 to 7.7 ± 2.17 p <0,001) Conclusion: Doxorubicin-induced repolarization is impaired and heterogeneity develops. It was observed that dysfunction was continued mechanically with the distortion of circumferential, radial strain and torsion in strain ECO, which accompanied electrical dysfunction. Cardiotoxicity should be evaluated together electrically and mechanically.