Stroke Volume/drug effects

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Research Letter

New Insights into Medical Therapy for Heart Failure with Preserved Ejection Fraction

Eduardo Thadeu de Oliveira Correia et al. Evandro Tinoco Mesquita

Introduction

Heart failure (HF) phenotypes can be divided into categories according to the left ventricular ejection fraction (EF) – HF with preserved EF (HFpEF; EF ≥ 50%); HF with mildly reduced EF (HFmrEF; EF 41-49%) and HF with reduced EF (HFrEF; EF ≤ 40%). However, HF phenotypes differ beyond just a different EF. While HFpEF develops from an interplay of comorbidities that lead to structural heart disease and HF symptoms, HFrEF usually develops due to a cardiac insult that reduces cardiac output.^, Moreover, while multiple therapies can improve the prognosis of HFrEF, only sodium-glucose cotransporter 2 inhibitors (SGLT2i) improved outcomes in HFpEF in a randomized controlled trial (RCT). In this letter, we explore evidence for medical therapies that could benefit HFpEF patients.

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Original Article

Arterial Stiffness Use for Early Monitoring of Cardiovascular Adverse Events due to Anthracycline Chemotherapy in Breast Cancer Patients. A Pilot Study

Cláudio Antônio de Souza et al. Ricardo Simões Karina Braga Gomes Borges Angélica Navarro de Oliveira … Juliana Barroso Zogeib Bruno Alves Marcus Vinicius Bolívar Malachias Ana Paula Drummond-Lage Bruno Almeida Rezende

Abstract

Background:

Chemotherapy with doxorubicin and cyclophosphamide, although efficient for treating breast cancer, is associated with cardiovascular complications. Recent studies seek to identify methods that can early detect cardiological and vascular changes as a strategy to decrease the incidence of cardiovascular comorbidities.

Objective:

To evaluate the role of arterial stiffness measurement in the monitoring of doxorubicin and cyclophosphamide-induced cardiotoxicity in breast cancer patients.

Methods:

Prospective longitudinal study in 24 breast cancer patients undergoing treatment with doxorubicin and cyclophosphamide. Patients underwent an indirect evaluation of arterial stiffness through non-invasive measurement of hemodynamic parameters such as pulse wave velocity with the Mobil-O-Graph® 24H PWA device at three different times of the chemotherapy treatment (pre-chemotherapy, after the first and the fourth cycle). The left ventricular ejection fraction was also evaluated by Doppler echocardiography (pre-chemotherapy and after the fourth chemotherapy cycle). Data were considered significant when p ≤ 0.05.

Results:

Patients had a mean age of 52.33 ± 8.85 years and body mass index of 31 ± 5.87 kg/m². There was no significant difference between the hemodynamic parameters evaluated by the oscillometric method or in the left ventricular ejection fraction in the different evaluated periods.

Conclusion:

Evaluations of arterial stiffness by oscillometry and measurement of left ventricular ejection fraction by Doppler echocardiography showed equivalence in the values found, suggesting that the evaluation method of arterial stiffness studied could be used as a marker for cardiovascular adverse events associated with doxorrubicin-based chemotherapy drugs.

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Letter to the Editor

Assessment of Diastolic Dysfunction: Drugs Could Alter the Results

Emre Yalcinkaya et al. Murat Celik Baris Bugan

To the Editor,

We read with great interest the article by El Aouar et al., entitled “Relationship between left atrial volume and diastolic dysfunction in 500 Brazilian patients”, which was published in the previous issue of Arquivos Brasileiros de Cardiologia. The authors aimed to evaluate the relationship between left atrial volume index and different grades of diastolic dysfunction in Brazilian patients submitted to echocardiogram. Although we commend the authors for the detailed and valuable information that they have provided, some comments may be beneficial.

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New Insights into Medical Therapy for Heart Failure with Preserved Ejection Fraction

Introduction

Arterial Stiffness Use for Early Monitoring of Cardiovascular Adverse Events due to Anthracycline Chemotherapy in Breast Cancer Patients. A Pilot Study

Abstract

Background:

Objective:

Methods:

Results:

Conclusion:

Assessment of Diastolic Dysfunction: Drugs Could Alter the Results

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