The Cardiac Effects of Radiotherapy on Women with Breast Cancer Based on Laterality

AUTHORS

Azin Alizadehasl ORCID 1 , Majid Maleki ORCID 2 , Feridoun Noohi ORCID 3 , Sara Adimi 4 , Seyed Amirhossein Emami ORCID 5 , Seyed Asadollah Mousavi ORCID 6 , Robab Anbiaie 7 , Payam Azadeh ORCID 8 , Hosein Kamranzadeh Fumani ORCID 6 , Soraya Salmanian ORCID 9 , Behshid Ghadrdoost ORCID 10 , Khadije Mohammadi ORCID 11 , Shirin Habibi Khorasani ORCID 1 , *

1 Cardio-Oncology Research Center, Rajaie Cardiovascular Medical and Research Center, Tehran, IR Iran

2 Echocardiography Research Center, Rajaie Cardiovascular Medical and Research Center, Tehran, IR Iran

3 Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Tehran, IR Iran

4 Department of Exercise Physiology, Central Tehran Branch, Islamic Azad University, Tehran, IR Iran

5 Department of Medical Education, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, IR Iran

6 Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, IR Iran

7 Department of Radiotherapy, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran

8 Department of Radiation Oncology, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran

9 Oncopathology Research Center, Faculty of Medicine, Iran University of Medical Sciences, Tehran, IR Iran

10 Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran

11 Cardiovascular Research Center, Kerman University of Medical Sciences, Kerman, IR Iran

How to Cite: Alizadehasl A, Maleki M , Noohi F, Adimi S, Emami S A , et al. The Cardiac Effects of Radiotherapy on Women with Breast Cancer Based on Laterality, Int Cardio Res J. 2030 ; 15(1):e112489.

ARTICLE INFORMATION

International Cardiovascular Research Journal: 15 (1); e112489
Published Online: March 30, 2021
Article Type: Research Article
Received: December 25, 2020
Accepted: February 22, 2021
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Abstract

Background: Recent advances in the early detection and management of breast cancer
have conferred longer patient survival. Breast irradiation-induced cardiotoxicity
has been associated with a decrease in the echocardiographic markers of myocardial
function and an increase in cardiac mortality.
Objectives: This study aimed to determine the cardiac effects of radiotherapy on patients
with breast cancer based on cancer laterality.
Methods: The present study assessed the records of 72 consecutive women with breast
cancer who were referred to the Cardio-Oncology Department of Rajaie Cardiovascular
Medical and Research Center between April 2017 and September 2020 and had
baseline echocardiographic examinations and at least one follow-up echocardiographic
examination within the first year of the initial examination. The patients were divided
into left- and right-sided breast cancer groups to compare the results. The two groups
were compared regarding the means of 2D Left Ventricular Ejection Fraction (LVEF),
3D LVEF, Global Longitudinal Strain (GLS), and Global Circumferential Strain (GCS)
before and after radiotherapy. Analysis of Covariance (one-way ANCOVA) was used
to compare the results (alpha = 0.05). All analyses were carried out using the SPSS
software, version 26.
Results: The changes in the means of 2D LVEF, 3D LVEF, GLS, and GCS were statistically
significant among all the patients irrespective of cancer laterality (P < 0.001, P < 0.001, P
= 0.001, and P = 0.002, respectively). However, no significant differences were observed
between the left- and right-sided breast cancer groups vis-à-vis the means of 2D LVEF,
3D LVEF, GLS, and GCS (P = 0.44, P = 0.65, P = 0.21, and P = 0.25, respectively).
Conclusions: The study results showed significant declines in the means of 2D LVEF,
3D LVEF, GLS, and GCS following radiotherapy. The patients with right-sided breast
cancer exhibited a significant decrease in all the mentioned measures, whereas those
with left-sided breast cancer showed no significant decline in post-radiotherapy speckletracking
parameters. In addition, comparison of the patients with left- and right-sided
breast cancers revealed no significant difference in the echocardiographic parameters of
cardiotoxicity regarding cancer laterality.

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