Short- an long-term cardiac responses to iatrogeic exposures
Kézdi Árpád
KÁROLY RÁCZ CONSERVATIVE MEDICINE PROGRAM
Dr. Fekete Andrea
SE Belgyógyászati és Onkológiai Klinika, Simonyi terem
2026-09-18 15:30:00
Anyagcsere betegségek
Dr. Lakatos Péter
Dr. Tabák Gy. Ádám
Kálmánné Dr. Istenes Ildikó
Dr. Vágvölgyi Anna
Dr. Domján Gyula
Dr. Kempler Miklós
Dr. Nyiraty Szabolcs
Cardiac function is influenced by a variety of physiological and pathological factors acting over different time scales. Short-term exposures primarily affect cardiac electrophysiology, whereas long-term exposures can induce structural and functional alterations of the myocardium. Both mechanisms affect the risk of arrhythmias and overall cardiovascular health, but the type and extent of their effects differ.
In this thesis, we investigated two clinically relevant exposures: acute hypoglycaemia in type 1 diabetes and different chemotherapeutic regimens give for breast cancer. In type 1 diabetes, we performed continuous ECG and glucose monitoring in free-living patients. Our findings showed no significant changes during daytime hypoglycaemic episodes. Night-time hypoglycaemias were associated with a slight prolongation of QTc and increased variability of several ECG intervals, although mean heart rate and the frequency of ventricular ectopias remained unchanged. These results suggest that while the theoretical risk of malignant arrhythmias exists, it is extremely low in otherwise healthy patients and unlikely to represent a major concern for individual glycaemic targets.
For breast cancer patients, we investigated trajectories of echocardiographic measures in a retrospective cohort of women treated with either anthracycline–taxane combination therapy or taxane-only regimens. EF was used to evaluate systolic function, while DT and E/e’ ratio for diastolic function. Anthracycline plus taxane treatment led to temporary reductions in EF and DT, which recovered over time. Single taxane therapy was not associated with clinically relevant alterations in any measured parameters. These observations indicate that taxane-based regimens are generally safe from a cardiological perspective, while anthracycline-containing treatments require careful monitoring.
In summary, these two studies illustrate the differences in the effect of short- and long-term cardiovascular exposures on the heart. Acute hypoglycaemia induces subtle electrophysiological alterations with a very low risk of serious arrhythmias, while anthracycline-based chemotherapy can temporarily impair myocardial function, particularly in diastolic performance. Our findings underscore the value of modality-specific monitoring – ECG for acute electrical instability and echocardiography for long-term functional changes – and provide evidence to inform clinical management strategies aimed at minimizing cardiovascular risk in both patient populations.
