Myocardial strain imaging by cardiac magnetic resonance for detection of subclinical myocardial dysfunction in breast cancer patients receiving trastuzumab and chemotherapy

Our objectives were to evaluate the temporal changes in CMR-based strain imaging, and examine their relationship with left ventricular ejection fraction (LVEF), in patients treated with trastuzumab. In this prospective longitudinal observational study, 41 women with HER2+ breast cancer treated with...

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Bibliographic Details
Published in:International journal of cardiology 2018-06, Vol.261, p.228-233
Main Authors: Ong, Geraldine, Brezden-Masley, Christine, Dhir, Vinita, Deva, Djeven P., Chan, Kelvin K.W., Chow, Chi-Ming, Thavendiranathan, Dinesh, Haq, Rashida, Barfett, Joseph J., Petrella, Teresa M., Connelly, Kim A., Yan, Andrew T.
Format: Article
Language:English
Subjects:
Adult
Antineoplastic Agents, Immunological - administration & dosage
Antineoplastic Agents, Immunological - adverse effects
Breast Neoplasms - diagnostic imaging
Breast Neoplasms - drug therapy
Breast Neoplasms - epidemiology
Cardiac magnetic resonance imaging
Cardiotoxicity
Chemotherapy
Echocardiography - methods
Female
Humans
Left ventricular ejection fraction
Left ventricular strain
Longitudinal Studies
Magnetic Resonance Imaging, Cine - methods
Middle Aged
Prospective Studies
Radionuclide Ventriculography - methods
Receptor, ErbB-2
Trastuzumab
Trastuzumab - administration & dosage
Trastuzumab - adverse effects
Ventricular Dysfunction, Left - chemically induced
Ventricular Dysfunction, Left - diagnostic imaging
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Summary:Our objectives were to evaluate the temporal changes in CMR-based strain imaging, and examine their relationship with left ventricular ejection fraction (LVEF), in patients treated with trastuzumab. In this prospective longitudinal observational study, 41 women with HER2+ breast cancer treated with chemotherapy underwent serial CMR (baseline, 6, 12, and 18 months) after initiation of trastuzumab (treatment duration 12 months). LVEF and LV strain (global longitudinal[GLS] and circumferential[GCS]) measurements were independently measured by 2 blinded readers. Of the 41 patients, 56% received anthracycline-based chemotherapy. Compared to baseline (60.4%, 95%CI 59.2–61.7%), there was a small but significant reduction in LVEF at 6 months (58.4%, 95%CI 56.7–60.0%, p = 0.034) and 12 months (57.9%, 95%CI 56.4–59.7%, p = 0.012), but not at 18 months (60.2%, 95%CI 58.2–62.2%, p = 0.93). Similarly, compared to baseline, GLS and GCS decreased significantly at 6 months (p = 0.024 and 
ISSN:0167-5273
1874-1754
DOI:10.1016/j.ijcard.2018.03.041