• Irena Gigovska Dimova Department of Urgent Medicine and Intensive Care, City General Hospital 8 September, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia


anthracyclines, breast cancer, echocardiography, ejection fraction, longitudinal strain


Background: Anthracyclines (ATs) are the most frequent used anti-cancer drugs in breast cancer (BC) patients. Certain demographic parameters and risk factors are closely linked to anthracycline-induced cardiotoxicity manifestation as the most feared adverse effect. 

Aims: The study aimed to assess the differences in selected echocardiographic parameters related to LV systolic function including longitudinal strain (LS%) according to cardiovascular (CV) risk factors and demographic characteristics and their relations in BC patients treated with ATs.

Methods: Thirty patients with newly diagnosed BC scheduled to receive ATs were examined. The following demographic parameters and risk factors were evaluated: age, body mass index, obesity, hypertension, diabetes, physical activity and total AT dose. The echocardiographic evaluation consisted of parameters for LV systolic function estimation, including LV ejection fraction (LVEF%) and LS%. Statistical analysis was done with the SPSS, v.25.0.

Results: LVEF%, GLS%, and LS% in two/four chamber view (A4c/A2c) statistically significantly decreased at the control evaluation (p=0.036, p=0,002, p=0,031, p=0,019). Correlation between the differences in LVEF% between two visits showed a significant relation with the absence of physical activity (p=0,029), while a significant correlation of the LS% decrease was also found in A4c view with diabetes (p=0.024).

Conclusion: ATs initiate frequent echocardiography changes in BC patients. Close monitoring and regular surveillance ensure early diagnosis of serious cardiotoxic complications. Cancer therapy-related cardiac dysfunction (CTRCD) is a broad spectrum of possible presentations, and serial LVEF% and LS% measurement are ideal tools to identify the disease in early, asymptomatic stage and guide further therapeutic strategies.


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