Assessment of left ventricular function by CMR versus MUGA scans in breast cancer patients receiving trastuzumab: a prospective observational study

• Published in: The International Journal of Cardiovascular Imaging 2019-11, Vol.35 (11), p.2085-2093
• Main Authors: Dhir, Vinita, Yan, Andrew T., Nisenbaum, Rosane, Sloninko, Joanna, Connelly, Kim A., Barfett, Joseph, Haq, Rashida, Kirpalani, Anish, Chan, Kelvin K. W., Petrella, Teresa M., Brezden-Masley, Christine
• Format: Article
• Language: English
• Subjects: Adult; Antineoplastic Agents, Immunological - adverse effects; Biomarkers; Biomarkers - blood; Brain; Brain natriuretic peptide; Breast cancer; Breast Neoplasms - drug therapy; Calcium-binding protein; Cardiac Imaging; Cardiac-Gated Imaging Techniques; Cardiology; Cardiotoxicity; Correlation analysis; Correlation coefficient; Correlation coefficients; ErbB-2 protein; Female; Health risk assessment; Heart; Humans; Imaging; Immunotherapy; Magnetic resonance; Magnetic Resonance Imaging; Medicine; Medicine & Public Health; Middle Aged; Monitoring; Monoclonal antibodies; Natriuretic Peptide, Brain - blood; Observational studies; Original Paper; Peptide Fragments - blood; Predictive Value of Tests; Prospective Studies; Radiation; Radiation effects; Radiology; Radiopharmaceuticals - administration & dosage; Reproducibility of Results; Risk Factors; Sodium Pertechnetate Tc 99m - administration & dosage; Stroke Volume - drug effects; Targeted cancer therapy; Time Factors; Tomography, Emission-Computed; Trastuzumab; Trastuzumab - adverse effects; Treatment Outcome; Troponin; Troponin I - blood; Ventricle; Ventricular Dysfunction, Left - chemically induced; Ventricular Dysfunction, Left - diagnostic imaging; Ventricular Dysfunction, Left - physiopathology; Ventricular Function, Left - drug effects
• ISSN: 1569-5794; 1573-0743; 1875-8312
• DOI: 10.1007/s10554-019-01648-z

Little is known about the comparison of multiple-gated acquisition (MUGA) scanning with cardiovascular magnetic resonance (CMR) for serial monitoring of HER2+ breast cancer patients receiving trastuzumab. The association of cardiac biomarkers with CMR left ventricular (LV) function and volume is also not well studied. Our objectives were to compare CMR and MUGA for left ventricular ejection fraction (LVEF) assessment, and to examine the association between changes in brain natriuretic peptide (NT-BNP) and troponin-I and changes in CMR LV function and volume. This prospective longitudinal two-centre cohort study recruited HER2+ breast cancer patients between January 2010 and December 2013. MUGA, CMR, NT-BNP and troponin-I were performed at baseline, 6, 12, and 18 months after trastuzumab initiation. In total, 41 patients (age 51.7 ± 10.8 years) were enrolled. LVEF comparison between MUGA and CMR demonstrated weak agreement (Lin’s correlation coefficient r = 0.46, baseline; r = 0.29, 6 months; r = 0.42, 12 months; r = 0.39, 18 months; all p