N. Kananchuk, S. Kananchuk, E. Petrova, M. Abramovich, N. Kazlouskaya, N. Mitkovskaya
Purpose. To evaluate the effect of complex treatment of breast cancer (BC) on the parameters of systolic myocardial function, and the efficiency of the prescription of cardiotropic therapy (CT) – a fixed combination of valsartan and carvedilol – in the prevention of the identified changes. To develop a mobile application, namely, an electronic statistical alculator for calculating the left ventricular ejection fraction by Simpson during BC treatment with anthracyclines, using the baseline anthropometric and instrumental data of the patient.
Methods. We evaluated the cardiovascular health of 100 women who received complex treatment of BC. The patients were divided into three groups, depending on the presence of arterial hypertension and the prescription of CT. In the study, all women received a complex evaluation of the cardiovascular health at the beginning and at the end of BC treatment
Results. In the non-CT group after the end of complex BC treatment the following was found: a decrease in the shortening fraction (FS) from 41.0 (38.0; 45.0)% to 38.0 (35.0; 43.0)%, (p < 0.05), in ejection fraction (EF) by Teinholz from 72.0 (69.0; 76.0)% to 68.0 (64.0; 73.0)%, (p < 0.05); in ejection fraction by Simpson from 66.0 (62.0; 71.0)% to 60.0 (57.0; 66.0)%, (p < 0.05); an increase in the vagosympathetic interaction LF/HF index (ratio of low frequency (LF) to high-frequency (HF) components) from 0.8 (0.7; 1.0) to 1.05 (0.8; 1.2), (p < 0.05); reduction of brachial artery diameter change from 12.5 (11.0; 16.0)% to 9.0 (6.0; 12.0)%, (p < 0.05). A model of the prognosis of EF by Simpson during BC treatment was proposed, which included a total dose of doxorubicin calculated per body surface area, early diastolic rate of transtricuspid blood flow, diameter of the trunk of the pulmonary artery, the rate of circular shortening of myocardial fibers, thickness of the intima-media complex of the left carotid arteries, HF, % of brachial artery diameter change. The prognosis model formed the basis for the development of the mobile application for predicting left ventricular systolic function during BC treatment with anthracyclines. We proposed a model for prediction of LVEF by Simpson against during breast cancer treatment, which included the total doxorubicin dose calculated per body surface area, early diastolic rate of transtricuspidal blood flow, pulmonary artery trunk diameter, myocardial fiber circular shortening rate, left carotid artery intima-media complex thickness, HF, percentage of brachial artery diameter change. The prognostic model formed the basis for the development of the mobile application for predicting left ventricular systolic function during BC treatment with anthracyclines.
keywords: calculator, anthracycline induced cardiovascular toxicity, ejection fraction.
for references: Mobile application for predicting left ventricular systolic function during breast cancer treatment with anthracyclines. Neotlozhnaya kardiologiya i kardiovaskulyarnye riski [Emergency cardiology and cardiovascular risks], 2023, vol. 7, no. 1, pp. 1793–1799.
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