The Utility of Cardiac Biomarkers, Tissue Velocity and Strain Imaging, and Cardiac Magnetic Resonance Imaging in Predicting Early Left Ventricular Dysfunction in Patients With Human Epidermal Growth Factor Receptor II–Positive Breast Cancer Treated With Adjuvant Trastuzumab Therapy

Autor: Jonathan R. Walker, Tielan Fang, Nazanin Fallah-Rad, Sheena Bohonis, Marianne Krahn, Matthew Lytwyn, Davinder S. Jassal, Anthony W. Wassef, Debjani Grenier, Pawan K. Singal, Iain D.C. Kirkpatrick, Ganhong Tian
Jazyk: angličtina
Předmět:
Pathology
drug safety
Receptor
ErbB-2
heart failure
fluorouracil
heart left ventricle failure
Ventricular Dysfunction
Left
Trastuzumab
dipeptidyl carboxypeptidase inhibitor
Natriuretic Peptide
Brain
skin and connective tissue diseases
Cardiac imaging
clinical article
C reactive protein
Ejection fraction
medicine.diagnostic_test
cancer adjuvant therapy
Antibodies
Monoclonal
beta adrenergic receptor blocking agent
Heart
Middle Aged
Echocardiography
Doppler
trastuzumab
C-Reactive Protein
tissue velocity imaging
drug withdrawal
Cardiology
Female
Cardiology and Cardiovascular Medicine
biological markers
medicine.drug
Adult
medicine.medical_specialty
diagnostic imaging
cardiotoxicity
Magnetic Resonance Imaging
Cine
Breast Neoplasms
brain natriuretic peptide
Antibodies
Monoclonal
Humanized
Risk Assessment
Sensitivity and Specificity
doxorubicin
cardiovascular magnetic resonance
transthoracic echocardiography
Breast cancer
breast cancer
strain
Troponin T
Cardiac magnetic resonance imaging
Internal medicine
medicine
Adjuvant therapy
cardiac MRI
Humans
treatment duration
business.industry
treatment response
biomarkers
Magnetic resonance imaging
medicine.disease
Peptide Fragments
drug efficacy
Heart failure
heart left ventricle endsystolic volume
cyclophosphamide
epidermal growth factor receptor 2
business
cardiomyopathy
heart left ventricle ejection fraction
Zdroj: Journal of the American College of Cardiology. (22):2263-2270
ISSN: 0735-1097
DOI: 10.1016/j.jacc.2010.11.063
Popis: Objectives: The aim of this study was to evaluate whether cardiac biomarkers, tissue velocity (TVI) and strain imaging, and cardiac magnetic resonance imaging can predict early left ventricular (LV) dysfunction in human epidermal growth factor receptor IIpositive breast cancer patients treated with trastuzumab in the adjuvant setting. Background: Early indexes of LV systolic dysfunction with noninvasive cardiac imaging would be useful for addressing the cardiac safety profile of trastuzumab, potentially avoiding the detrimental effects of heart failure. Methods: We used cardiac biomarkers, TVI and strain imaging, and cardiac magnetic resonance imaging to detect pre-clinical changes in LV systolic function, before conventional changes in left ventricular ejection fraction (LVEF) in human epidermal growth factor receptor IIpositive breast cancer patients treated with trastuzumab in the adjuvant setting. Results: Of 42 patients (mean age 47 ± 9 years) prospectively followed between 2007 and 2009, 10 (25%) developed trastuzumab-mediated cardiomyopathy (CM). Troponin T, C-reactive protein, and brain natriuretic peptide did not change over time. Within 3 months of adjuvant therapy with trastuzumab, there was a significant difference in the lateral S′ between the normal cohort and the CM group (9.1 ± 1.6 cm/s and 6.4 ± 0.6 cm/s, respectively, p < 0.05). Similarly, the peak global longitudinal and radial strain decreased as early as 3 months in the trastuzumab-mediated cardiotoxicity group. As compared with both global longitudinal and radial strain, only S′ was able to identify all 10 patients who developed trastuzumab-mediated CM. The LVEF subsequently decreased at 6 months of follow-up in all 10 patients, necessitating discontinuation of the drug. All 10 patients demonstrated delayed enhancement of the lateral wall of the LV within the mid-myocardial portion, consistent with trastuzumab-induced CM. Conclusions: Both TVI and strain imaging were able to detect pre-clinical changes in LV systolic function, before conventional changes in LVEF, in patients receiving trastuzumab in the adjuvant setting. © 2011 American College of Cardiology Foundation.
Databáze: OpenAIRE
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