Análise da função diastólica em mulheres medicadas com antraciclínicos no tratamento do câncer de mama

Abstract

Breast cancer is one of the most important public health of our country. It was estimated for 2010, 49,400 new cases of breast cancer in Brazil, with an estimated risk of 51 cases per 100 000 women. The treatment strategy of patients with breast tumors can pass through the use of chemotherapy. Doxorubicin is one of the most active drugs for breast cancer, belonging to the group of anthracyclines. The family of anthracyclines has as side effect myocardial damage that can reach 36% depending on the dose used. The effect on the myocardium is known to occur most commonly during or shortly after the last cycle of chemotherapy, but it could occur several years after the last cycle of chemotherapy. The objective of this study was to evaluate changes in left ventricular diastolic function in women users of anthracyclines in the treatment of breast cancer. A prospective study in a cohort of women aged 18 to 69 years, with breast cancer and indications for chemotherapy with doxorubicin. We follow a period of not less than 18 months a group of 38 patients who met the eligibility criteria. The doxorubicin dose used ranged from 50 to 60 mg / m² / SC. All patients were female, and carriers of infiltrating ductal carcinoma histology. Two patients died during the study of noncardiac causes. In our view, the end of the study showed that the parameters: size of left atrium (LA), left ventricular (LV) dimensions in diastole, left ventricular dimensions in systole, E wave velocity, ratio of phase rapid filling by atrial systole, late diastolic velocity of mitral annulus, early diastolic velocity of mitral annulus, deceleration time and speed ratio early rapid filling of the LV early diastolic velocity of mitral annulus proved to be useful parameters for monitoring of cardiac injury by anthracyclines. Although this did not occur with: fractional shortening, ejection fraction, LA volume, LA volume corrected for body surface area, late diastolic velocity, isovolumetric relaxation time, mitral annular systolic velocity, which showed no significant changes in this study. The analysis of diastolic function using echocardiography proved to be an effective method, which, together with the systolic function allows early detection of possible myocardial damage, arising the use of chemotherapy with anthracycline, favoring an early and appropriate therapeutic intervention.