Relationship Between Quality of Life Indicators and Cardiac Status Indicators in Chemotherapy Patients.

With the aim of improving personalized treatment of patients on chemotherapy, the objective of the study was to assess the degree of association between selected Quality of life (QoL) indicators and both clinical and imaging cardiac status indicators when detecting deterioration in QoL of these patients. In a cohort clinical study in Hamburg, from August 2017 through October 2020, 59 cancer patients, aged 18-80 years, were evaluated before chemotherapy, and at several follow-ups, using EQ-5D and SF-36 QoL questionnaires, fast strain-encoded (fast-SENC) cardiac magnetic resonance (CMR), conventional CMR, and echocardiography, and further received a clinical and biomarker examination. Data was analyzed using survival analyses. A decline of more than 5% in each observed QoL metric value was defined as the observed event. Patient were separated into groups according to the presentation of cardiotoxicity as per its clinical definition, the establishment of the indication for cardioprotective therapy initiation, and by a worsening in the value of each observed imaging metric by more than 5% in the previous follow-up compared to the corresponding pre-chemotherapy baseline value. Among clinical cardiac status indicators, the indication for cardioprotective therapy showed statistically good association with QoL scores (EQ-5D p=0.028; SF-36 physical component p=0.016; SF-36 mental component p=0.012). In terms of imaging metrics, the MyoHealth segmental myocardial strain score was the only one demonstrating consistently good QoL score association (EQ-5D p=0.005; SF-36 physical component p=0.056; SF-36 mental component p=0.002). Established fast-SENC CMR scores are capable of highlighting patients with reduced QoL, who require more frequent/optimal management. Z namenom izboljšati personalizirano zdravljenje bolnikov, ki prejemajo kemoterapijo, je bil cilj naše raziskave oceniti stopnjo povezanosti med izbranimi kazalniki kakovosti življenja (QoL) ter kliničnimi in slikovnimi kazalniki srčnega statusa v kontekstu zaznave poslabšanja QoL teh bolnikov. V kohortni klinični študiji v Hamburgu smo od avgusta 2017 do oktobra 2020 59 bolnikom z rakom, starim 18–80 let, pred kemoterapijo in več kontrolnimi pregledi, napravili oceno QoL z vprašalnikoma EQ-5D in SF-36, hitro z deformacijo miokarda kodirano (fast-SENC) magnetnoresonančno slikanje srca (CMR), konvencionalno CMR, ultrazvočni pregled srca ter klinični pregled z določitvijo biomarkerjev. Podatke smo analizirali z analizo preživetja. Upad za več kot 5 % v vrednosti posameznega opazovanega kazalnika QoL je bil izbran kot opazovani dogodek. Razdelitev bolnikov v skupine je bila definirana glede na pojav kardiotoksičnosti po njeni klinični definiciji, postavitev indikacije za zdravljenje z zdravili za zaščito srčne mišice ter na osnovi poslabšanja vrednosti posameznega opazovanega slikovnega kazalnika za več kot 5 % ob zadnjem kontrolnem pregledu v primerjavi z njegovo vrednostjo pred pričetkom kemoterapije. Med kliničnimi kazalniki srčnega statusa je postavitev indikacije za zdravljenje z zdravili za zaščito srčne mišice pokazala statistično dobro povezanost s kazalniki QoL (EQ-5Dp = 0,028; SF-36 telesna komponenta p = 0,016; SF-36 mentalna komponenta p = 0,012). Med slikovnimi kazalniki je bila MyoHealth ocena segmentne krčljivosti miokarda edina, ki je pokazala konsistentno dobro povezanost s kazalniki QoL (EQ-5D p = 0,005; SF-36 telesna komponenta p = 0,056; SF-36 mentalna komponenta p = 0,002). Uveljavljeni fast-SENC kazalniki CMR so se pokazali za sposobne izpostaviti bolnike z zmanjšano QoL, ki potrebujejo pogostejšo/optimalnejšo obravnavo.

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© 2021 National Institute of Public Health, Slovenia, published by Sciendo.

Déclaration de conflit d'intérêts

Conflicts of interest Henning Steen, Arne Kristian Schwarz, Sebastian Kelle, Grigorios Korosoglou and Daniel Lenihan hold a consulting position at and/or are in research collaboration with Myocardial Solutions, Inc. Other authors declare that no conflicts of interest exist.