P1458Prognostic value of T wave axis deviation for left ventricular dysfunction in patients with complete left bundle branch block Article Swipe
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· 2017
· Open Access
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· DOI: https://doi.org/10.1093/eurheartj/ehx502.p1458
Purpose: To describe the differences between sub-acute and late onset cardiotoxicity in regard to LVEF recovery as well as all-cause mortality.Methods: Our analysis comprised of 91oncologic patients diagnosed between 1998 and 2016 as cardiomyopathy with impaired systolic function following chemotherapy or biological therapy.All were evaluated and followed at the heart failure outpatient clinics at Sheba Medical Center.The study population was defined according to two main categories; sub-acute and late onset cardio-toxicity.Recovery of LVEF (to ≥50%) and total mortality constitutes the primary end points of the analysis.Results: 53 (58%) patients were classified as sub-acute, while 38 (42%) as late onset cardio-toxicity.There were no major differences in baseline clinical characteristics between the two categories.However those with sub-acute onset were more likely to receive Trastuzumab 29 (55%) as part of their treatment regimen compared to those in the late onset category 2 (6%), P<0.001.The main types of malignancy were breast carcinoma 29 (55%), and 20 (53%) in in sub-acute and late, respectively and lymphoma in 18 (34%) vs. 10 (26%) in sub-acute and late, respectively.The mean LVEF among those with sub-acute onset was 37% compared to 28% among those with late onset cardio-toxicity (P<0.001).Patients with sub-acute onset were more likely to fully recover their ejection fraction 32 (64%) compared to 7 (22%) among those in the late onset group (P<0.001).Independent predictors of recovery of systolic function were Trastuzumab therapy (HR=9.83;95% CI 1.74-55.4,P=0.01), and higher LVEF at baseline (HR=1.08;95% CI 1.01-1.16,P=0.028).There were no significant differences in mortality when comparing those with sub-acute vs. late onset cardio-toxicity and only a trend for reduced mortality in those who normalized their LVEF.Conclusions: Early detection of Onco-therapy induced cardio-toxicity and treatment initiation may play an important factor for LVEF recovery.Both sub-acute and late-onset cardio-toxicity appear to respond to contemporary heart failure therapy improving the prognosis of cardio-oncological patients.
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- https://doi.org/10.1093/eurheartj/ehx502.p1458
- https://academic.oup.com/eurheartj/article-pdf/38/suppl_1/ehx502.P1458/19621127/ehx502.P1458.pdf
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