Slide Presentations: Tuesday, October 25, 2011 |

Angiotensin-Converting Enzyme (ACE) Inhibitors Prevent Anthracycline-Induced Alterations of the Left Ventricular Systolic Performance, With No Influence on Mitral Diastolic Filling Indices' Deterioration, in Patients Treated for Lung Cancer FREE TO VIEW

Dan Radulescu, MD; Andrea Parv, MD; Maria Radulescu, MD; Paulina Mitrea, PhD
Chest. 2011;140(4_MeetingAbstracts):1006A. doi:10.1378/chest.1118934
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PURPOSE: Impairment of left ventricular (LV) function is a well-established consequence of anthracyclines.In the present study we tried to find out if treatment with ACE inhibitors can prevent LV systolic and diastolic dysfunction in lung cancer patients treated with anthracycline-containing regimens.

METHODS: Eighty-two patients with lung cancer, treated with epirubicin-cyclophosphamide (EC) chemotherapy protocol concurrent with ACE inhibitor (perindopril 4 mg/day) (study group) and a gender- and age-matched group of 82 individuals with the same oncologic pathology, treated with EC chemotherapy alone (control group) were assessed by Doppler echocardiography. LV function was evaluated, by measuring the transmitral inflow indices: maximal velocity of the E and A waves (rapid filling and atrial filling), pressure half time (PHT) of E wave, isovolumic relaxation time (IVRT) and E wave deceleration time (DT). Systolic function was assessed using the global ejection fraction.. Analysis of data included between-group and intra-group comparison of variations in LV function at baseline and after treatment completion.

RESULTS: At the end of treatment, the LV diastolic filling indices were less altered in the study group compared to the control group where a significant decrease of Emax, and an increase of Amax , prolonged IVRT, PHT and E wave DT were certified . The LV ejection fraction was within normal limits in the study group, less altered compared to the control group, proving significant difference between the 2 groups at the end-point of our study.

CONCLUSIONS: Our data suggest LV systolic and diastolic dysfunction after anthracycline-containing chemotherapy. The associated treatment with ACE inhibitors prevented a severe deterioration of LV diastolic function and conserved systolic performance.

CLINICAL IMPLICATIONS: The treatment with ACE inhibitors in lung cancer survivors prevented a severe deterioration of LV diastolic function and conserved systolic performance.

DISCLOSURE: The following authors have nothing to disclose: Dan Radulescu, Andrea Parv, Maria Radulescu, Paulina Mitrea

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