The role of pulmonary vein flowmetry in predicting chemotherapy-induced cardiotoxicity
Keywords:
cardiotoxicity, chemotherapy, diastolic function, tissue Doppler, pulmonary vein flow, echocardiographyAbstract
Background: Chemotherapy-induced cardiotoxicity may manifest as diastolic dysfunction and heart failure with preserved ejection fraction. Echocardiographic assessment of diastolic function includes mitral inflow, tissue Doppler, and pulmonary vein flow, although their predictive value in this context remains controversial.
Objective: To analyze and synthesize the available scientific evidence on the role of pulmonary vein flow as an echocardiographic tool for the early detection of chemotherapy-induced cardiotoxicity and to evaluate its applicability in low-resource clinical settings.
Methods: A narrative literature review was conducted of original articles and reviews published in the last 10 years in PubMed, SciELO, and Scopus, focusing on diastolic function and the current value of pulmonary vein flow as a predictor of chemotherapy-induced cardiotoxicity.
Development: Pulmonary vein flow can detect early elevation of filling pressures and left ventricular stiffness before a decline in ejection fraction occurs. It is a promising echocardiographic tool for the early detection of cardiotoxicity. However, its routine use is limited by technical complexity, low reproducibility, and limited availability in low-resource settings, where mitral and tissue Doppler are more accessible and validated.
Conclusions: Pulmonary vein flow represents a physiopathologically promising parameter capable of reflecting early hemodynamic alterations in atrioventricular function, guiding the detection of diastolic dysfunction and cardiotoxicity.
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