Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Early prevention of cardiotoxicity: focus on inhibitors of sodium-glucose co-transporter 2

Authors: Buziashvili Yu.I.1, Stilidi I.S.2, Matskeplishvili S.T.1, Asymbekova E.U.1, Tugeeva E.F.1, Artamonova E.V.2, 3, 4, Akhmedyarova N.K.1, Akildzhonov F.R.1

Company:
1 Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation
2 National Medical Research Center of Oncology named after N.N. Blokhin, Moscow, Russian Federation
3 N.I. Pirogov Russian National Research Medical University, Moscow, Russian Federation
4 Moscow Regional Research and Clinical Institute named after M.F. Vladimirsky, Moscow, Russian Federation

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DOI: https://doi.org/10.24022/1814-6910-2023-20-3-288-299

UDC: 616.12-008.46:615.355

Link: Clinical Physiology of Blood Circulaiton. 2023; 3 (20): 288-299

Quote as: Buziashvili Yu.I., Stilidi I.S., Matskeplishvili S.T., Asymbekova E.U., Tugeeva E.F., Artamonova E.V., Akhmedyarova N.K., Akildzhonov F.R. Early prevention of cardiotoxicity: focus on inhibitors of sodium-glucose co-transporter 2. Clinical Physiology of Circulation. 2023; 20 (3): 288–99 (in Russ.). DOI: 10.24022/1814-6910-2023-20-3-288-299

Received / Accepted:  15.07.2023 / 17.08.2023

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Abstract

Objective. Analysis of echocardiographic parameters of the cardiovascular system in patients with breast cancer while receiving sodium-glucose co-transporter 2 (SGLT-2) during neoadjuvant chemotherapy (NAС).

Material and methods. The prospective study included 131 patients with a confirmed diagnosis of breast cancer during NAC, who underwent echocardiography at rest; assessed the main indicators of systolic, contractile and diastolic function before and after the end of NAC in two groups of patients: in the main group (n = 60), patients took dapagliflozin at a dose of 10 mg/day throughout the course of chemotherapy, and in the control group (n = 71) – without the use of dapagliflozin.

Results. Patients in the control group showed an increase in end-systolic volume. On average, the degree of decrease in ejection fraction (EF) in the group differed significantly: in patients who received dapagliflozin simultaneously with NAC, it was 4.2 ± 5.7%, and in the control group 7.3 ± 5.9% (p = 0.002). Moreover, treatment with dapagliflozin was clearly associated with a decrease in EF in a smaller number of patients (χ2 = 4.2, p = 0.04). NAC in the control group was accompanied by a significant deterioration in left ventricle (LV) myocardial relaxation. There were significantly more patients with deterioration in diastolic function during the course of NAC in the control group than in the main group. The most significant were the stiffness coefficient, LV systolic filling fraction, the ratio of the systolic wave of the pulmonary venous blood flow to the diastolic wave.

Conclusion. The use of SGLT-2 drugs during chemotherapy is accompanied by positive effects – less deterioration in systolic and diastolic function of the left ventricle compared to the control group.

About Authors

  • Yuriy I. Buziashvili, Dr. Med. Sci., Professor, Academician of the Russian Academy of Sciences, Head of Clinical and Diagnostic Department; ORCID
  • Ivan S. Stilidi, Dr. Med. Sci., Professor, Academician of the Russian Academy of Sciences, Director; ORCID
  • Simon T. Matskeplishvili, Dr. Med. Sci., Professor, Corresponding Member of the Russian Academy of Sciences, Chief Researcher; ORCID
  • Elmira U. Asymbekova, Dr. Med. Sci., Leading Researcher; ORCID
  • Elvina F. Tugeeva, Dr. Med. Sci., Senior Researcher; ORCID
  • Elena V. Artamonova, Dr. Med. Sci., Leading Researcher; ORCID
  • Nazli K. Akhmedyarova, Cand. Med. Sci., Researcher; ORCID
  • Firdavsdzhon R. Akildzhonov, Postgraduate; ORCID

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