Background
Materials and methods
Patients
Radiotherapy
Serum biomarker analysis
Echocardiographic examination
Statistical analysis
Results
TGF-β1, PDGF and proBNP
Before RT | After RT | Three years | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
n | Md | IQR | Md | IQR | Md | IQR | p1 | p2 | p3 | |
TGF-β1 (ng/ml) | 63 | 19.2 | (17.1–22.3) | 18.8 | (14.5–22.0) | 17.2 | (13.7–21.2) |
0.003
|
0.001
| 0.101 |
PDGF (ng/ml) | 63 | 15.4 | (12.6–19.1) | 13.8 | (11.7–16.2) | 15.6 | (10.4–18.4) |
0.001
|
0.046
| 0.661 |
proBNP (ng/l) | 62 | 75.5 | (42.5–125.5) | 75.0 | (35.5–132.8) | 101.0 | (55.5–183.3) | 0.325 |
< 0.001
|
< 0.001
|
TGF-β1 before RT | TGF-β1 after RT | TGF-β1 3 years | Change in TGF-β1 before RT–after RT | Change in TGF-β1 before RT–3 years | Change in TGF-β1 after RT–3 years | |
---|---|---|---|---|---|---|
PDGF before RT |
0.667
| 0.222 | 0.132 |
─0.405
|
─0.480
| ─0.088 |
PDGF after RT |
0.453
|
0.713
|
0.316
|
0.249
| ─0.141 |
─0.361
|
PDGF 3 years |
0.299
|
0.338
|
0.749
| 0.022 |
0.336
|
0.414
|
Change in PDGF before RT–after RT | ─0.221 |
0.481
| 0.246 |
0.646
|
0.363
| ─0.204 |
Change in PDGF before RT–3 years | ─0.254 | ─0.128 |
0.625
|
0.308
|
0.739
|
0.513
|
Change in PDGF after RT–3 years | ─0.132 |
─0.267
|
0.544
| ─0.152 |
0.600
|
0.826
|
proBNP before RT |
0.298
| ─0.037 | ─0.040 | ─0.325 | ─0.280 | ─0.050 |
proBNP after RT |
0.265
| ─0.041 | ─0.006 | ─0.252 | ─0.183 | ─0.005 |
proBNP 3 years |
0.293
| ─0.060 | ─0.061 | ─0.321 | ─0.297 | ─0.070 |
Change in proBNP before RT–after RT | ─0.040 | ─0.016 | 0.054 | 0.101 | 0.150 | 0.075 |
Change in proBNP before RT–3 years | 0.114 | 0.087 | 0.004 | ─0.023 | ─0.111 | ─0.129 |
Change in proBNP after RT–3 years | 0.212 | 0.018 | 0.004 | ─0.259 | ─0.232 | ─0.060 |
TGF-β1, PDGF and baseline characteristics
TGF-β1 and PDGF levels and echocardiographic measurements
Correlations with structural echocardiographic measurement
Correlations with systolic echocardiographic measurements
Correlations with measurements of filling pressure and diastology in echocardiography
TGF-β1 trajectories
n | Group 1 | n | Group 2 |
p
| |
---|---|---|---|---|---|
TGF-β1 before RT (ng/ml) Md (IQR) | 19 | 25.6 (22.3–28.6) | 44 | 17.8 (15.9–19.9) |
< 0.001
|
TGF-β1 after RT (ng/ml), Md (IQR) | 19 | 23.9 (21.3–25.2) | 44 | 16.3 (13.7–19.1) |
< 0.001
|
TGF-β1 at 3 years (ng/ml), Md (IQR) | 19 | 22.4 (18.8–25.8) | 44 | 15.0 (12.1–18.8) |
< 0.001
|
Age, Md (IQR) | 19 | 64 (58–66) | 44 | 64 (59–68) | 0.752 |
BMI, Md (IQR) | 19 | 26.9 (24.8–32.3) | 44 | 25.7 (24.1–28.7) | 0.110 |
Left-sided BC, n (%) | 19 | 14 (73.7) | 44 | 36 (81.8) | 0.508 |
AI-use, n (%) | 19 | 6 (31.2) | 44 | 15 (34.1) | 1.000 |
Tamoxifen use, n (%) | 19 | 2 (10.5) | 44 | 4 (9.1) | 1.000 |
ACE or ARB use, n (%) | 19 | 5 (26.3) | 44 | 12 (27.3) | 1.000 |
ASA use, n (%) | 19 | 1 (5.3) | 44 | 4 (9.1) | 1.000 |
Beta-blocker use, n (%) | 19 | 4 (21.1) | 44 | 7 (15.9) | 0.721 |
Statin use, n (%) | 19 | 3 (15.8) | 44 | 10 (22.7) | 0.738 |
CAD, n (%) | 19 | 2 (10.5) | 44 | 1 (2.3) | 0.214 |
Diabetes, n (%) | 17 | 3 (17.6) | 42 | 2 (4.8) | 0.138 |
Hypertension, n (%) | 19 | 9 (47.4) | 44 | 15 (34.1) | 0.400 |
Hypothyroidism, n (%) | 19 | 3 (15.8) | 44 | 7 (15.9) | 1.000 |
Smoking, n (%) | 19 | 2 (10.5) | 44 | 5 (11.4) | 1.000 |
Group 1 (n = 19) | Group 2 (n = 44) | |||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Before RT | After RT | 3 year | Before RT | After RT | 3 year | |||||||||||||
n | Md | (IQR) | Md | (IQR) | Md | (IQR) | p1 | p2 | n | Md | (IQR) | Md | (IQR) | Md | (IQR) | p1 | p2 | |
LV measurements | ||||||||||||||||||
LVEDD (mm) | 19 | 46.0 | (44.0–48.0) | 45.0 | (44.0–50.0) | 46.0 | (42.0–50.0) | 0.513 | 0.446 | 44 | 46.0 | (44.0–47.0) | 46.0 | (43.3–47.0) | 45.0 | (43.0–47.0) | 0.904 | 0.654 |
LVESD (mm) | 19 | 31.0 | (29.0–34.0) | 32.0 | (28.0–34.0) | 31.0 | (29.0–35.0) | 0.854 | 0.954 | 44 | 31.0 | (29.0–32.8) | 30.5 | (29.0–31.8) | 30.0 | (29.0–32.0) | 0.781 | 0.896 |
IVS (mm) | 19 | 10.0 | (9.0–11.0) | 11.0 | (10.0–12.0) | 11.0 | (10.0–11.0) |
0.036
| 0.157 | 44 | 10.0 | (9.0–11.0) | 10.0 | (9.0–11.0) | 10.0 | (9.0–11.0) | 0.378 | 0.775 |
PW (mm) | 19 | 10.0 | (9.0–11.0) | 11.0 | (10.0–12.0) | 9.0 | (10.0–11.0) |
0.030
| 0.434 | 44 | 10.0 | (9.0–11.0) | 10.0 | (9.3–11.0) | 9.0 | (8.3–10.0) | 0.144 |
0.028
|
LV systolic function | ||||||||||||||||||
LV EF (%) | 19 | 62.0 | (56.0–65.0 | 61.0 | (58.0–65.0) | 60.0 | (57.0–63.0) | 0.886 | 0.144 | 44 | 62.0 | (60.0–65.0 | 63 | (59.3–65.0) | 61.5 | (57.0–63.0) | 1.000 | 0.092 |
GLS (%) | 17 | ─17.0 | (─20.5-─16.0) | ─17.0 | (─19.5-─15.5) | ─16.0 | (─18.5-─14.0) | 0.373 |
0.006
| 44 | ─18.0 | (─19.8-─15.0) | ─17.0 | (─20.0-─15.0) | ─18.0 | (─20.0-─16.0) | 0.159 | 0.762 |
LV diastolic function | ||||||||||||||||||
Mitral inflow E (cm/s) | 19 | 73.5 | (66.2–81.9) | 66.1 | (57.2–79.0) | 66.2 | (61.7–78.4) | 0.113 | 0.106 | 44 | 75.4 | (63.8–87.3) | 72.4 | (60.3–80.0) | 71.4 | (62.0–89.0) | 0.139 | 0.242 |
Ee’ ratio | 19 | 8.3 | (6.8–10.2) | 7.8 | (7.1–11.1) | 8.7 | (7.1–10.2) | 0.701 | 0.347 | 44 | 9.5 | (7.7–11.4) | 9.3 | (7.1–10.2) | 8.9 | (7.7–11.0) | 0.076 | 0.337 |
RV function | ||||||||||||||||||
TAPSE (mm) | 17 | 24.0 | (21.0–28.0) | 21.0 | (18.5–24.5) | 22.0 | (20.5–27.5) |
0.021
| 0.363 | 42 | 24.5 | (20.8–27.3) | 22.0 | (19.0–26.0) | 24.0 | (20.0–26.0) |
0.001
| 0.119 |
TR gradient (mmHg) | 12 | 21.0 | (18.3–26.0) | 20.5 | (17.3–24.0) | 23.5 | (19.3–28.5) | 0.351 | 0.381 | 35 | 21.0 | (17.0–25.0) | 22.0 | (19.0–24.0) | 24.0 | (20.0–29.0 | 0.811 |
< 0.001
|
Tissue characterization | ||||||||||||||||||
scIBS (dB) | 17 | 15.5 | (12.5–21.3) | 19.5 | (13.7–25.1) | 23.3 | (20.1–25.8) |
0.031
|
< 0.001
| 44 | 17.6 | (14.1–22.1) | 19.6 | (16.3–24.2) | 20.3 | (18.8–22.8) |
0.007
|
0.002
|
rcIBS (dB) | 17 | 18.7 | (14.8–21.8) | 22.9 | (20.1–25.9) | 23.5 | (19.1–27.0) |
0.011
|
0.013
| 44 | 21.1 | (17.1–24.6) | 23.0 | (18.0–26.9) | 24.1 | (20.3–27.0) | 0.208 |
0.021
|
pcIBS (dB) | 17 | 10.3 | (7.6–11.9) | 9.2 | (8.2–12.1) | 9.4 | (6.5–13.1) | 0.579 | 0.854 | 43 | 9.8 | (6.8–13.9) | 10.3 | (8.3–12.5) | 10.5 | (6.8–13.4) | 0.888 | 0.959 |