Prevalence of abnormal echocardiographic findings in cancer patients: A retrospective evaluation of echocardiography for identifying cardiac abnormalities in cancer patients

Background: Transthoracic echocardiography (TTE) is commonly used to assess cardiac morphology and function in cancer patients. The nature, distribution, and prevalence of significant echocardiographic abnormalities are unknown. We hypothesized that TTEs performed for cancer or cancer treatment indications, have a high prevalence of significant abnormalities (SA), including a large proportion of findings that may be overlooked by other imaging modalities. Methods: All TTE studies performed in a tertiary cancer center over a six-month period, from January to June 2007, were reviewed. The TTEs were divided into studies performed for a cardiovascular indication (CV) and those done for a cancer-related indication (CA). Reports were classified as normal, mildly abnormal, and significantly abnormal (SA) based on findings. Abnormal findings' distributions were compared between indication groups. Results: Three thousand nine hundred and twenty-four TTEs were performed and divided into either group CV (61.2%) or group CA (38.7%). The most common indication in the CV group was valvular diseases (29.9%). In the CA group, the majority of TTE were requested for evaluation during or after chemotherapy or radiation (94.7%). Around 41.9% of studies in group CV were classified as SA whereas 19.9% (P < 0.001) in the CA group were classified as such. The relative distributions of individual SA findings were compared between the indication groups and were not statistically different. Conclusions: One in five patients who had TTE studies for CA were found to have SA, and 81.5% of these may not have been found with other modalities. The TTE allows safe diagnosis of a wide range of abnormal findings that may be overlooked if alternative but less versatile modalities are used.