Noninvasive Measures of Ventricular-Arterial Coupling and Circumferential Strain Predict Cancer Therapeutics–Related Cardiac Dysfunction

Abstract Objectives This study sought to determine the relationships between echocardiography-derived measures of myocardial mechanics and cancer therapeutics–related cardiac dysfunction (CTRCD). Background Doxorubicin and trastuzumab are highly effective breast cancer therapies, but have a substant...

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Bibliographic Details
Published in:JACC. Cardiovascular imaging 2016-10, Vol.9 (10), p.1131-1141
Main Authors: Narayan, Hari K., MD, French, Benjamin, PhD, Khan, Abigail M., MD, Plappert, Theodore, RCVS, Hyman, David, BA, Bajulaiye, Akinyemi, BA, Domchek, Susan, MD, DeMichele, Angela, MD, MSCE, Clark, Amy, MD, MSCE, Matro, Jennifer, MD, Bradbury, Angela, MD, Fox, Kevin, MD, Carver, Joseph R., MD, Ky, Bonnie, MD, MSCE
Format: Article
Language:English
Subjects:
Adult
Antineoplastic Agents - adverse effects
Area Under Curve
Biomechanical Phenomena
Breast Neoplasms - drug therapy
cardio-oncology
Cardiotoxicity
Cardiovascular
Doxorubicin - adverse effects
Echocardiography
Elasticity
Female
Heart Diseases - chemically induced
Heart Diseases - diagnostic imaging
Heart Diseases - physiopathology
Humans
Linear Models
Logistic Models
Longitudinal Studies
mechanics
Middle Aged
Multivariate Analysis
Myocardial Contraction
Odds Ratio
Predictive Value of Tests
Prospective Studies
Risk Factors
ROC Curve
Stress, Mechanical
Stroke Volume
Time Factors
Trastuzumab - adverse effects
Ventricular Function
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Summary:Abstract Objectives This study sought to determine the relationships between echocardiography-derived measures of myocardial mechanics and cancer therapeutics–related cardiac dysfunction (CTRCD). Background Doxorubicin and trastuzumab are highly effective breast cancer therapies, but have a substantial risk of CTRCD. There is a critical need for the early detection of patients at increased risk of toxicity. Methods We performed a prospective, longitudinal cohort study of breast cancer participants undergoing doxorubicin and/or trastuzumab therapy. Echocardiography was performed prior to therapy initiation (baseline) and at standardized follow-up intervals during and after completion of therapy. Ejection fraction (EF), strain, strain rate, and ventricular-arterial coupling (effective arterial elastance [Ea]/end-systolic elastance [Eessb ]) were quantitated. CTRCD was defined as a ≥10% reduction in EF from baseline to 
ISSN:1936-878X
1876-7591
DOI:10.1016/j.jcmg.2015.11.024