Digestive cancer isDigestive cancer is cardiotoxic cardiotoxic

Introducere: Cardiovascular disease and cancer are the leading causes of mortality in Romania, being respon-sible for one death every three minutes. In Northwes-tern Romania, digestive cancers account for about 30% of all male neoplasias and about 20% for women. Due to common risk factors, patients with digestive cancers are at risk of cardiovascular disease and vice versa.
Objective: Assuming a that patient with digestive cancer is with cardiac frailty, our paper aims to detect changes in initial cardiac assessment of people with di-gestive cancers and presumed without heart disease.
Methods: 50 consecutive digestive neoplasia patients (Lot A) were compared with 50 consecutive patients without oncological pathology (Lot B); patients with a history of heart disease or cardiovascular treatment were not included.
Results: Regarding group A, the most common cancer was colorectal, followed by stomach, pancreatic, hepa-tic and esophageal cancer. Metastases were found in 31% of cases (all cancers), reflecting the delayed detec-tion of digestive cancers in Romania. In both groups, males were more than females and there were no sig-nificant age differences (60.4 vs. 64.2 years, p=0.79). The incidental discovery of atrial fibrillation was more common in group A (6 patients vs. 2 patients) and it was linked as a negative prognostic factor; 5 of the pa-tients with atrial fibrillation also had metastases. Echo-cardiographic parameters analysis: there were no significant differences in TAS (137 mmHg vs. 130 mmHg), TAD (82.5 mmHg vs. 84 mmHg), VS ejection fraction (57.1% vs. 58%), longitudinal function LV assessed by Septal S-wave TDI (7.79 cm /s vs. 8.04 cm /s, 95% CI (-1.217- 0.733)) or isovolumetric contraction time – TDI (42 ms vs. 40 ms). Significant difference was ob-served for isovolumic relaxation time (92.18 ms vs. 84.8 ms, 95% CI (0.37-15.3)), suggesting possible sub-clinical diastolic impairment due to neoplasia, possibly due to both maintenance of inflammatory status and pareneoplastic syndromes. There were no significant differences in RV function, quantified by TAPSE (23.1 vs. 23.8 mm; p=0.89) or PSAP (27.48 mmHg vs. 24.6 mmHg; p=0.62). The presence of pericardial effu-sion (regardless of quantity) was significantly higher in group A (n=9 vs. n=2); some recent studies support the idea of pericarditis as a marker for occult cancer and a negative prognostic marker of patients diagnosed with cancer.
Conclusions: Digestive neoplasias predispose to car-diological damage; these patients having a higher risk of developing atrial fibrillation, pericarditis or possibly diastolic dysfunction. Initial cardiac evaluation, prior to specific therapy, brings important information about prognosis of the disease and helps establish a less cardi-otoxic chemotherapy regimen.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)