Unit:
Τομέας ΠαθολογίαςLibrary of the School of Health Sciences
Author:
Kapelakis Ioannis
Dissertation committee:
Χριστόδουλος Στεφανάδης, Καθηγητής, Ιατρική, ΕΚΠΑ
Δημήτριος Τούσουλης, Καθηγητής, Ιατρική, ΕΚΠΑ
Αριστοτέλης Μπάμιας, Καθηγητής, Ιατρική, ΕΚΠΑ
Κωνσταντίνος Τούτουζας, Αν.Καθηγητής, Ιατρική, ΕΚΠΑ
Ελευθέριος Τσιάμης, Αν.Καθηγητής, Ιατρική, ΕΚΠΑ
Σάββας Τουμανίδης, Καθηγητής, Ιατρική, ΕΚΠΑ
Χρίστος Παπαδημητρίου, Καθηγητής, Ιατρική, ΕΚΠΑ
Original Title:
Προοπτική μελέτη υπερηχογραφικών δεικτών συστολικής και διαστολικής λειτουργίας της αριστερής κοιλίας σε ογκολογικούς ασθενείς οι οποίοι λαμβάνουν συστηματική χορήγηση Bevacizumab.
Translated title:
Prospective study of systolic and diastolic function of left ventricle in patients treated with bevacizumab
Summary:
Abstract
Background: Bevacizumab, is an anti-angiogenic agent recently used widely in the treatment of cancer. Limited data support an increase of the thrombotic events in patients receiving bevacizumab.
Objectives: The aim of the present study was to evaluate the incidence of cardiovascular events in patients treated with bevacizumab, and to identify prognostic clinical, electrocardiographic, and echocardiographic factors of the effect of bevacizumab on cardiovascular system.
Methods: One hundred and forty seven patients were prospectively included in the study. The patients were divided into two groups. Group 1 received conventional chemotherapeutic scheme with bevacizumab and group 2 similar chemotherapeutic schemes without bevacizumab. All patients were prospectively followed up at 6 and 18 months.
Results: Seventy six patients (65.21±10.49 years) were treated with bevacizumab and 71 patients (65.11±11.3 years) without bevacizumab. Cardiovascular events were higher in the bevacizumab group compared to the controls (7/76 [9.21%] versus 1/71 [1.40%], p=0.03). From the echocardiographic indexes evaluating the myocardial systolic function, the Sa was lower both at 6 and 18 months (10.93±4.64 versus 9.90±3.59 cm/s, p<0.001 and 10.93±4.64 vs 9.03±9.56 cm/s, p=0.003). Regarding the diastolic function, E/E΄ ratio increased both at 6 months and at 18 months (5.83±2.53 vs 7.86±3.45, p<0.001 and 5.83±2.53 vs 7.84±3.45, p= 0.004). Multivariate analysis identified left bundle branch block (LBBB), and bevacizumab as independent predictors of cardiovascular events. (p<0.001 HR: 56.72, for LBBB and p=0.03, HR: 13.18, for bevacizumab)
Conclusion: Bevacizumab is associated with increased incidence of cardiovascular events and has impact in systolic and diastolic function of left ventricle. LBBB is an independent risk factor for future cardiovascular events.
Main subject category:
Health Sciences
Keywords:
Bevacizumab, Cardiovascular events, Systolic and diastolic function
Number of references:
160
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Ioannis Kapelakis-phd thesis.pdf
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