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Nuclear medicine diagnostic tools for early detection of myocardial damage in treated breast cancer patients

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Tzonevska A., Tzvetkov K., Atanasova M., Chakarova A.
OncoReview
|
2014
|
vol. 4
|
issue 3
A93-99
EN
The most severe side effect in treated patients with breast cancer is treatment-induced cardiotoxicity, leading to chronic heart failure or CAD, and worsening the patient’s quality of life. The early detection and medical protection is needed to prevent it. The aim of the study was to detect early signs of cardiotoxicity. Material and methods: 148 breast cancer patients were included in the study: 64 after combined treatment (chemo- and radiotherapy), 56 patients after radiotherapy, 28 patients after chemotherapy. We performed myocardial scintigraphy (GSPECT-CT), EchoCG, proBNP measurement. Results: The analysis of the results present early signs of cardiotoxicity in 46% of investigated patients. Exclusion criteria were: patients with cardiac symptoms, pathologic ECG and LVEF. EchoCG results indicated normal systolic function in all (n = 120) patients (mean LVEF 64%), in 79 (66%) patients – normal diastolic function, in 41 (34%) patients diastolic dysfunction was found. Myocardial scintigraphy: normal systolic function was found in all patients (mean LVEF 68%), no segmental dysfunction, diastolic dysfunction had 47 (32%) patients. Hypoperfused myocardial segments were found in 39 (26%) patients. Normal myocardial perfusion had 125 (84%) patients. ProBNP: normal proBNP values were measured in 64 patients, increased values – in 7 (9%) patients. Conclusion: The results indicated earlier detection of signs of cardiotoxicity in comparison to the routine diagnostic methods. Applying myocardial GSPECT-CT, we can detect early signs of myocardial damage before positive results from routine tests for cardiotoxicity and before severe morphologic myocardial damage.
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