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Iranian Heart Journal، جلد ۲۰، شماره ۱، صفحات ۲۰-۳۱
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عنوان انگلیسی Efficacy of Treatment With Carvedilol in Preventing Early-Stage Left Ventricular Dysfunction in Patients With Breast Cancer Candidated to Receive Trastuzumab Using 2D Speckle-Tracking Echocardiography
چکیده انگلیسی مقاله Background: Treatment-induced cardiotoxicity is one of the major side effects of trastuzumabtreatment in patients with breast cancer. Left ventricular (LV) dysfunction is the leading causeof treatment-induced cardiotoxicity. The development of treatment-induced cardiotoxicityduring cancer treatment may force patients to modify or quit the treatment. In this trial, weevaluated the prophylactic effects of carvedilol on LV dysfunction in patients with breast cancerreceiving trastuzumab using 2D speckle-tracking echocardiography (2DSTE).Methods: We conducted an open-label randomized clinical trial and enrolled 71 non-metastatic HER-2positive patients with breast cancer candidated to receive trastuzumab. Carvedilol wasadministered concomitantly with the trastuzumab standard regimen at a dosage of 6.25 mgtwice a day and up-titrated to the maximum tolerated dosage. The 2DSTE parameters toevaluate the LV systolic and diastolic functions were evaluated initially and 3 monthsthereafter.Results: Thirty-six patients were randomly assigned to the carvedilol group and 35 patients to thecontrol group. The mean left ventricular ejection fraction (LVEF) was not significantly differenteither in both groups or between the 2 groups (P=.61) during the follow-up. In contrast, theglobal longitudinal strain of the LV (GLS) (P=.000) and the strain rate of the LV systolicfunction (SRS) (P=.004) as markers of the LV systolic function were reduced in the controlgroup. Furthermore, the LV strain rate of the early (SRE) and late (SRA) diastolic functionswere preserved in the patients who received prophylactic carvedilol (P=.000 and P=.005,respectively).Conclusions: Concomitant carvedilol treatment with a maximum tolerable dose in patients with nonmetastatic HER2-positive breast cancer under treatment with trastuzumab might be effective onthe reduction of systolic and diastolic echocardiographic findings other than the LVEF inpatients with weak markers of heart failure.
کلیدواژه‌های انگلیسی مقاله Cardioprotection, Carvedilol, Trastuzumab, Breast cancer
نویسندگان مقاله Maryam Moshkani Farahani |
Atherosclerosis Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran

Saeed Nourian |
Atherosclerosis Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran

Hamed Reza Jalalian |
School of Medicine, Baqiyatallah University of Medical Sciences, Tehran, IR Iran

Arezoo Khosravi |
Atherosclerosis Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran

Mahmmod Salesi |
Chemical Injuries Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran

نشانی اینترنتی http://journal.iha.org.ir/article_82789_a325e40aca5e6ffcce1dc74a968f7e21.pdf
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