Key result
Radiotherapy-induced T-wave decline was independently associated with mean heart radiation dose (β=1.252, p=0.001) and global systolic strain rate change (β=7.943, p=0.002).
Why the study?
Does radiotherapy induce early ECG changes that correlate with echocardiographic changes in patients with early-stage breast cancer?
Observational (n=80)
Does radiotherapy induce early ECG changes that correlate with echocardiographic changes in patients with early-stage breast cancer?
Radiotherapy-induced ECG changes, particularly T-wave alterations, are prevalent and correlate with structural and functional echocardiographic changes, suggesting ECG could be a useful screening tool for post-radiotherapy cardiac effects.
Answers are grounded in this paper and cite their sources.
T-wave decline may flag early cardiotoxicity after breast radiotherapy; hypothesis-generating for ECG screening, needs prospective validation before practice change.
BACKGROUND: Early electrocardiogram (ECG) changes after breast cancer radiotherapy (RT) have been reported, but their characteristics and associated factors are largely unknown. This study aimed to explore early RT-induced ECG changes and to compare them with echocardiography changes. MATERIALS AND METHODS: Sixty eligible patients with chemotherapy-naïve left-sided and 20 with right-sided breast cancer were evaluated with echocardiography, blood samples and ECG before and after RT. RESULTS: RT-induced ECG changes in the anterior leads. T-Wave changes were most frequent. T-Wave decline was associated independently with patient age (β=-0.245, p=0.005), mean heart radiation dose (β=1.252, p=0.001) and global systolic strain rate change (β=7.943, p=0.002). T-Wave inversion was associated independently with mean heart radiation dose (β=0.143, p<0.001), global longitudinal strain change (β=0.053, p=0.017) and posterior calibrated integrated backscatter (β=-0.022, p=0.049). CONCLUSION: RT-induced ECG changes were prevalent and associated with functional and structural changes in echocardiography. ECG could be used for post-RT cardiac screening.
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Tuohinen et al. (2018) conducted an observational in Early-stage breast cancer (n=80). Radiotherapy vs. Baseline (before radiotherapy) was evaluated on Early ECG changes (T-Wave decline and inversion) (β=1.252 (for T-Wave decline and mean heart radiation dose), p=0.001). Radiotherapy-induced T-wave decline was independently associated with mean heart radiation dose (β=1.252, p=0.001) and global systolic strain rate change (β=7.943, p=0.002).
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