The influence of the hormone therapy for prostatic cancer on the ventricular repolarization and global longitudinal strain

Objective: To evaluate the cardiac effects of luteinizing hormone-releasing hormone (LHRH) antagonists in advanced prostate cancer by determining the surface ECG parameters of electrical instability and the global longitudinal strain.
Methods: There were 34 men (pts) with advanced pro-static cancer treated byorchiectomy and LHRH antagonist degarelix. We noted clinical history and excluded patients with atrial fibrillation, heart failure (HF) NYHA III and IV class, acute myocardial infarction (MI) in the last 6 months, chronic renal disease stages IV-V. We performed ECG, Holter ECG, echocardiography and evaluated QT interval dispersion (QTd), Tpeak-Tend interval (Tpe), J-Tpeak interval (JT), (in V5), Lown class ventricular premature beats (VPB) on Holter ECG, left ventricular ejection fraction (LVEF), global longitudinal strain (GLS) by speckle trecking technique before the beginning of the treatment (V1), after 3 (V2) and 6 months (V3). We used Epi Info 8 pro-gram: paired t-test for comparing the differences and correlation test.
Results: Patients were 69.8±10 years old. 26 (76.47%) had arterial hypertension, 18 (52.9%) stable angina, 8 (23.5%) old myocardial infarction, 7 (20.8%) diabetes mellitus, 7 (20.8%) chronic renal disease grade 1-3b. They were stable during the study. 23 (67.64%) pati-ents had a simultaneous increase of the QTd (+ QTd) and JT (+Δ JT) between V1 and V3. Mean +Δ QTd was 83±10 ms, mean +Δ JTwas 78±30 ms, both statistical significant (p<0.05). Tpe changes were variable. 20 (58.82%) patients had a decrease of the GLS (- ΔGLS) between V1 and V3. Mean – ΔGLS was 1.5% .There was a significant correlation between + QTd, +Δ JT and – ΔGLS (r=-0.3) Mean LVEF was 60±5%, stable between V1 and V3. We did not note an increase in the number or severity of VPB between V1, V2 and V3.
Conclusions: There is a significant rising tendency of QTd, JT values and a decreasing tendency of GLS values in pts with advanced prostatic cancer receiving LHRH antagonist for 6 months. No increase was no-ted in the number or severity of VPB during the first 6 months of treatment.

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)