P375 To evaluate the effectiveness of primary prevention of anthracycline cardiotoxicity using modern STE technologies
Authors: Nesvetov V V , Vasyuk Y U A , Shkolnik E L , Yushuk E N 
Published: January 2020

Abstract

Funding Acknowledgements
without financial supports

Introduction
Despite the high efficiency, the use of chemotherapeutic drugs involves to the development of cardiomyopathy and heart failure. Correction of myocardial damage is most effective before the appearance of clinical manifestations of cardiomyopathy.
Aim of study. To evaluate the effectiveness of primary prevention of anthracycline cardiotoxicity using modern STE technologies.
Material and methods.The study included 65 patients with breast cancer. All patients had a collection of anamnesis, echocardiography with STE , were performed before the study. All patients were prescribed chemotherapy with anthracycline, after which the patients included in the study were randomly randomized into two groups. Patients of the first group, in which 27 patients were included, were additionally assigned ivabradine in a daily dose of 10 mg, followed by titration of the dose to achieve a heart rate of less than 70 beats per minute. The comparison group consisted of 38 patients who received only chemotherapy.

Results
A six-month treatment with ivabradine was accompanied by a significant decrease in heart rate by the first month (from 83.6 ± 9.5 to 67.1 ± 7.5 bpm, p &lt;0.001) and persisted until the sixth month (from 83.6 ± 9.5 Up to 74.2 ± 14.9 beats per minute, p &lt;0.001). The analysis of echocardiographic indices did not reveal significant differences between the groups.The reliable dynamics of the LV ejection fraction was not detected in both groups.To assess the effect of ivabradine on the development of subclinical systolic dysfunction of the left ventricle during chemotherapy, a global longitudinal systolic deformation was also evaluated. The groups did not differ in terms of global longitudinal strain (-20.4 ± 1.8% in the ivabradine group and -19.9 ± 2.0% in the control group). In the control group, there was a tendency to decrease global deformation (from -19.9 ± 2.0% to -19.0 ± 1.8% by 3 months to -18.9 ± 1.7% by the 6th month of observation), and in Group of ivabradine, the deformation parameters were at a stable level (from -20.4 ± 1.8% to-20.6 ± 2.4% by 3 months and -20.4 ± 1.9% by the 6th month of observation), which led to significant differences between groups at the first and third and sixth month of observation (-21.1 ± 1.8% to 1 month and -20.6 ± 2.4% to 3 months and -20.4 ± 1.9% to 6 months in the ivabradine group compared to -19.6 ± 2.1% to 1 Month and -19.0 ± 1.8% by 3 months and -18.9 ± 1.7 by the 6th month of observation p &lt;0.05 in the control group).
Conclusions.Therapy with ivabradine in patients with breast cancer with heart rate&gt; 70 beats per minute is safe. The appointment of ivabradine is accompanied by a significant decrease in the number of patients with complaints of heart beat, contributes to the preservation of normal global longitudinal deformation of the left ventricle against chemotherapy, while in the control group has a negative dynamics with a maximum at the 6th month of follow-up