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. 2023 Feb 19;12(4):1652.
doi: 10.3390/jcm12041652.

Serial Non-Invasive Myocardial Work Measurements for Patient Risk Stratification and Early Detection of Cancer Therapeutics-Related Cardiac Dysfunction in Breast Cancer Patients: A Single-Centre Observational Study

Ana Moya  1   2 , Dimitri Buytaert  1 , Monika Beles  1 , Pasquale Paolisso  1 , Jürgen Duchenne  3 , Greet Huygh  4 , Ciska Langmans  4 , Adelheid Roelstraete  4 , Sofie Verstreken  1 , Marc Goethals  1 , Riet Dierckx  1 , Jozef Bartunek  1 , Martin Penicka  1 , Guy Van Camp  1 , Ward A Heggermont  1   3 , Marc Vanderheyden  1
Affiliations

Serial Non-Invasive Myocardial Work Measurements for Patient Risk Stratification and Early Detection of Cancer Therapeutics-Related Cardiac Dysfunction in Breast Cancer Patients: A Single-Centre Observational Study

Ana Moya et al. J Clin Med. .

Abstract

Serial transthoracic echocardiographic (TTE) assessment of LVEF and GLS are the gold standard in screening Cancer Therapeutics-Related Cardiac Dysfunction (CTRCD). Non-invasive left-ventricle (LV) pressure-strain loop (PSL) emerged as a novel method to quantify Myocardial Work (MW). This study aims to describe the temporal changes and longitudinal trajectories of MW indices during cardiotoxic treatment. We included 50 breast cancer patients with normal LV function referred for anthracycline therapy w/wo Trastuzumab. Medical therapy, clinical and echocardiographic data were recorded before and 3, 6, and 12 months after initiation of the chemotherapy. MW indices were calculated through PSL analysis. According to ESC guidelines, mild and moderated CTRCD was detected in 10 and 9 patients, respectively (20% CTRCDmild, 18% CTRCDmod), while 31 patients remained free of CTRCD (62% CTRCDneg). Prior to chemotherapy MWI, MWE and CW were significantly lower in CTRCDmod than in CTRCDneg and CTRCDmild. Overt cardiac dysfunction in CTRCDmod at 6 months was accompanied by significant worse values in MWI, MWE and WW compared to CTRCDneg and CTRCDmild. MW features such as low baseline CW, especially when associated with a rise in WW at follow-up, may identify patients at risk for CTRCD. Additional studies are needed to explore the role of MW in CRTCD.

Keywords: Cancer Therapeutics-Related Cardiac Dysfunction; Myocardial Work; anthracyclines; cardiotoxicity; pressure–strain loops; speckle tracking.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Temporal changes and trajectories of LVEF, GLS and MW indices in CTRCDneg (green), CTRCDmild (blue) and CTRCDmod (red) group. ° CTRCDmod vs. CTRCDneg; * CTRCDmod vs. CTRCDmild; + CTRCDmod vs. CTRCDneg + mild; p ≤ 0.05.
Figure 2
Figure 2
PSL analysis for CTRCDneg (green), CTRCDmild (blue) and CTRCDmod (red) at 12 M follow-up.
Figure 3
Figure 3
An illustrative example of temporal changes in LVP, GLS and MWI, graphically represented by the PSL area, in three different patients without and with mild or moderate CTRCD. Black: BL, brown: 3 M, orange: 6 M, purple: 12 M.
See this image and copyright information in PMC

References

    1. Gavila J., Seguí M., Calvo L., López T., Alonso J.J., Farto M., la Rosa R.S.-D. Evaluation and management of chemotherapy-induced cardiotoxicity in breast cancer: A Delphi study. Clin. Transl. Oncol. 2017;19:91–104. doi: 10.1007/s12094-016-1508-y. - DOI - PMC - PubMed
    1. Pizzino F., Vizzari G., A Bomzer C., Qamar R., Carerj S., Zito C., Khandheria B.K. Diagnosis of Chemotherapy-Induced Cardiotoxicity. J. Patient-Centered Res. Rev. 2014;1:121–127. doi: 10.17294/2330-0698.1025. - DOI
    1. Volkova M., Russell R. Anthracycline Cardiotoxicity: Prevalence, Pathogenesis and Treatment. Curr. Cardiol. Rev. 2012;7:214–220. doi: 10.2174/157340311799960645. - DOI - PMC - PubMed
    1. Procter M., Suter T.M., de Azambuja E., Dafni U., Van Dooren V., Muehlbauer S., Climent M.A., Rechberger E., Liu W.T.-W., Toi M., et al. Longer-term assessment of trastuzumab-related cardiac adverse events in the Herceptin Adjuvant (HERA) trial. J. Clin. Oncol. 2010;28:3422–3428. doi: 10.1200/JCO.2009.26.0463. - DOI - PubMed
    1. Santoro C., Esposito R., Lembo M., Sorrentino R., De Santo I., Luciano F., Casciano O., Giuliano M., De Placido S., Trimarco B., et al. Strain-oriented strategy for guiding cardioprotection initiation of breast cancer patients experiencing cardiac dysfunction. Eur. Heart J. Cardiovasc. Imaging. 2019;20:1345–1352. doi: 10.1093/ehjci/jez194. - DOI - PubMed

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