Evaluation of Tricuspid Annular Plane Systolic Excursion (TAPSE) in cancer patients undergoing anthracycline-based therapy: A pre–post study

Abstract

Introduction: Anthracycline-based chemotherapy is effective in treating various cancers but is known for dose-dependent cardiotoxicity, typically affecting the left ventricle (LV). Recent studies have suggested that the right ventricle (RV) may also be impacted. Tricuspid Annular Plane Systolic Excursion (TAPSE) is a non-invasive echocardiographic tool that assesses RV systolic function. This study aims to evaluate the effects of anthracycline chemotherapy on TAPSE and explore its correlation with LV ejection fraction (LVEF). Aim: To investigate the impact of anthracycline chemotherapy on RV function using TAPSE and to assess the relationship between changes in TAPSE and LVEF in cancer patients. Methods: This pre-post observational study included 74 cancer patients receiving anthracycline-based chemotherapy, specifically, Doxorubicin, at Wahidin Sudirohusodo General Hospital. Echocardiographic measurements of TAPSE and LVEF were performed before and after chemotherapy. Statistical analyses included Mann–Whitney, Wilcoxon signed-rank, and Kruskal–Wallis tests to evaluate changes in TAPSE and LVEF. Results: After chemotherapy, 79.7% of patients showed a significant decrease in TAPSE (mean reduction: 2.2 mm, p = 0.001). TAPSE decreased from 20.8 ± 2.3 mm pre-treatment to 18.6 ± 2.7 mm post-treatment. A significant positive correlation was found between changes in TAPSE and LVEF (r = 0.62, p = 0.001). Conclusions: Anthracycline chemotherapy leads to significant RV dysfunction, as indicated by reduced TAPSE, which correlates with LV dysfunction. TAPSE is a valuable tool for early detection of biventricular cardiotoxicity in cancer patients undergoing anthracycline treatment.

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