ABC | Volume 112, Nº1, January 2019

Original Article Barros et al Regional wall motion and cardiotoxicity prediction Arq Bras Cardiol. 2019; 112(1):50-56 Table 3 – Univariate analyses of predictors related of cardiotoxicity Variable O.R. 95% CI p Age 1.03 [0.99; 1,07] 0.151 LVDD 1.22 [0.99; 1.50] 0.061 LVSD 1.69 [1.35; 2.12] 0.000 Diastolic dysfunction 3.55 [1.34; 9.44] 0.011 Regional wall motion abnormality 8,91 [2.75; 28.82] 0.000 LA 0.95 [0.78; 1.16] 0.624 GLS 1.96 [1.25; 3.09] 0.022 PASP 1.86 [0.32; 10.99] 0.491 BNP 1.24 [00.91; 1.70] 0.306 Troponin 3.36 [0.49; 23.14] 0.219 Creatinine 0.04 [0.00; 2.20] 0.113 Hemoglobin 0.90 [0.60; 1.35] 0.608 Sodium 1.01 [0.98; 1.03] 0.623 Potassium 1.33 [0.51; 3.51] 0.559 Calcium 1.06 [0.81; 1.39] 0.657 Magnesium 6.20 [0.67; 57.73] 0.204 Hypertension 0.79 [0.26; 2.39] 0.673 Dyslipidemia 0.41 [0.07; 2.21] 0.298 Diabetes 1.15 [0.15; 8.83] 0.894 LVDD: left ventricular diastolic dimension; LVSD: left ventricular systolic dimension; GLS: global longitudinal strain; LA: left atrium dimension; PASP: pulmonary artery systolic pressure; BNP: brain natriuretic peptidium. Table 4 – Multivariate analysis of predictors related of cardiotoxicity Variable O.R. 95% CI p LVSD 1.34 [1.01; 1.79] 0.044 Regional wall motion abnormality 6.25 [1.03; 37.95] 0.046 GLS 1,48 [1,02; 2.12] 0.036 LVSD: left ventricular systolic dimension; GLS: global longitudinal strain. Limitations All patients were recruited from one center and the study consisted of a limited number of patients. The study was limited by a short duration of patient follow-up, and therefore any possible long term impact of the early echocardiography abnormalities are uncertain. Long term follow up is therefore necessary to determine the significance of these early observations. The proposed treatment was individually defined, including the use of cardio-protective drugs, which may have influenced our results. Conclusion In this prospective cohort of 112 patients undergoing treatment with chemotherapy for breast cancer, we found segmental wall motion abnormality to be a strong predictor of cardiotoxicity. Therefore, assessment of segmental wall motion might be a useful tool in the evaluation of patients at risk of developing CTRCT, resulting in early detection of myocardial dysfunction and potential reduction in morbidity and mortality in these patients. Author contributions Conception and design of the research and critical revision of the manuscript for intellectual contente: Barros MVL, Macedo AVS, Sarvari SI, Faleiros MH, Felipe PT, Silva JLP, Edvardsen T; acquisition of data: Barros MVL, Faleiros MH, Felipe PT; analysis and interpretation of the data: Barros MVL, Macedo AVS, Sarvari SI, Silva JLP; statistical analysis: Silva JLP; writing of the manuscript: Barros MVL, Macedo AVS, Sarvari SI, Felipe PT, Edvardsen T. 54