Identification of Subclinical Myocardial Dysfunction in Breast Cancer Patients With Metabolic Syndrome After Cancer Related Comprehensive Therapy
Abstract Background: Breast cancer patients with metabolic syndrome have an increased risk of cardiovascular disease. These patients are more prone to suffer from cardiotoxicity after anti-cancer therapy. Patients after completion of cancer related comprehensive therapy, who show normal myocardial function, may already have subclinical myocardial dysfunction. We sought to evaluate the subclinical myocardial dysfunction in breast cancer patients with metabolic syndrome after cancer related comprehensive therapy.Methods: In this study, 45 breast cancer patients with metabolic syndrome after completion of cancer related comprehensive therapy and 45 non-breast cancer patients with metabolic syndrome were enrolled. Left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS) were measured using echocardiogram. Results: All the patients have normal LVEF. However, nine breast cancer patients (20%) had GLS that was lower than -17%, while all the non-cancer patients have normal GLS. Breast cancer patients with metabolic syndrome had a decrease of GLS and LVEF, compared with non-cancer patients with metabolic syndrome. Furthermore, we found that decrease of age was associated with reduction of LVEF, and that use of trastuzumab for 1 year was a significant factor that associated with reduction of GLS.Conclusions: Breast cancer patients with metabolic syndrome after completion of cancer related comprehensive therapy suffered from subclinical myocardial dysfunction. GLS should be routinely performed to early identify subclinical myocardial damage of patients, in order to prevent the cardiotoxicity of cancer related comprehensive therapy.Trial registration: the Medical Ethics Committee of Peking University People’s Hospital, 2018PHB032-02, Registered 23 November 2018, http://www.chictr.org.cn/showproj.aspx?proj=35202