Cancer Therapy-Induced Right Ventricular Systolic and Diastolic Dysfunction Assessed Using Conventional Echocardiographic Indices: A Prospective Observational Study

Background/Objectives: Cancer treatment can impair right ventricular (RV) systolic and diastolic function by altering cardiomyocyte metabolism and inducing cell death. The incidence and prognosis of cancer therapy-induced RV involvement remain uncertain. We assessed RV diastolic changes and their association with systolic RV and LV dysfunction in cancer patients. Methods: We prospectively observed 60 adults (91.7% female, aged 31 to 74 years) with breast or gastrointestinal cancer receiving chemotherapy for a median of 381 days (IQR 187, 464), excluding those with cardiovascular or pulmonary disease. RV diastolic function was assessed using the 2010 right heart echocardiographic guidelines. RV systolic dysfunction was defined by abnormal values in at least two of the following RV indices: fractional area change (RVFAC), systolic tissue Doppler velocity (RVS’), tricuspid annular plane systolic excursion, or myocardial performance index. LV dysfunction was defined by abnormal LV ejection fraction or average systolic LV tissue Doppler velocity. Results: RV systolic dysfunction was found in 7 patients (11.7%), RV diastolic dysfunction in 12 (30.7%), and LV dysfunction in 11 (18.3%). Generalised estimating equations showed early decreases in RVS’ and RVFAC at the first month (β = −0.68, p = 0.016; β = −2.2, p = 0.006), and later changes in RV early diastolic tissue velocity (RVe′) and the ratio of early RV filling velocity (RVE) to RVe′ (RVE/e′) at the third month (β = −1.03, p = 0.005; β = 0.35, p = 0.034). Higher RVFAC values were linked to lower odds of LV dysfunction (OR 0.88, p = 0.002). RVe′ was associated with RV systolic dysfunction (OR 0.61, p < 0.001), with a threshold of 10 cm/s (AUC 0.81; 95% CI: 0.69, 0.93). Conclusions: Conventional echocardiographic parameters may facilitate the detection of RV systolic and diastolic dysfunction during cancer therapy. Early alterations and the prognostic value of RV parameters support the necessity for their routine monitoring.