Arq. Bras. Cardiol. 2019; 112(1): 57-58

Usefulness of Myocardial Deformation Indices in Preventing Cardiotoxicity in Breast Cancer Patients

Marcelo Dantas Tavares de Melo, Vera Maria Cury Salemi

DOI: 10.5935/abc.20190009

This Short Editorial is referred by the Research article "Left Ventricular Regional Wall Motion Abnormality is a Strong Predictor of Cardiotoxicity in Breast Cancer Patients Undergoing Chemotherapy".

The first description of chemotherapy-induced heart failure (Stage C) was published in 1967. There has been a therapeutic evolution in oncological treatment since then, as shown by the fact that, as of 2005, the survival rate exceeded that of mortality. This has resulted in a new epidemiological problem for these survivors, since at least 30% of them will show some degree of cardiotoxicity, which can occur up to decades after the end of the chemotherapy. Moreover, cardiovascular mortality is already considered the second most common cause of death, second only to cancer.^–

The classically accepted definition for cardiotoxicity during treatment was proposed in 2014, which described it as an absolute decrease in left ventricular (LV) ejection fraction of 10 percentage points to values below 53%, with its re-evaluation being recommended after 2 to 3 weeks. Additionally, the subclinical lesion is based on the relative decrease in global LV longitudinal strain by 15% in relation to the baseline. The major concern is that systolic dysfunction can lead to a therapeutic dose adjustment, less effective alternative therapy regimens, or, in the worst-case scenario, to chemotherapy discontinuation.

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