open access

Vol 23, No 3 (2016)
NON-INVASIVE IMAGING Original article
Published online: 2016-05-10
Submitted: 2015-12-24
Accepted: 2016-05-07
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Cardiac magnetic resonance imaging-based myocardial strain study for evaluation of cardiotoxicity in breast cancer patients treated with trastuzumab: A pilot study to evaluate the feasibility of the method

Shintaro Nakano, Masahiro Takahashi, Fumiko Kimura, Taiki Senoo, Toshiaki Saeki, Shigeto Ueda, Jun Tanno, Takaaki Senbonmatsu, Takatoshi Kasai, Shigeyuki Nishimura
DOI: 10.5603/CJ.a2016.0023
·
Cardiol J 2016;23(3):270-280.

open access

Vol 23, No 3 (2016)
NON-INVASIVE IMAGING Original article
Published online: 2016-05-10
Submitted: 2015-12-24
Accepted: 2016-05-07

Abstract

Background: Trastuzumab, used to treat breast cancer overexpressing human epidermal growth factor receptor 2, may be cardiotoxic. Cardiac magnetic resonance (CMR) imaging with myocardial strain studies has been used to evaluate subclinical biventricular myocardial changes, however, its clinical utility during chemotherapy has not been evaluated.

Methods: The clinical outcomes, CMR and cardiac biomarkers of 9 women aged 62.3 ± 12.6 years with early or locally advanced breast cancer were evaluated at baseline, and at 3, 6 and 12 months after the initiation of trastuzumab.

Results: None of the patients developed heart failure or elevated serum cardiac biomarkers. Global left ventricular (LV) peak systolic longitudinal and circumferential strains were significantly decreased at 6 months (longitudinal strains, –21.1 ± 1.7% [baseline] vs. –19.5 ± 1.0% [6 months], p = 0.039, and circumferential strains, –23.4 ± 1.8% [baseline] vs. –21.6 ± 2.5% [6 months], p = 0.036). These changes were analogous to those observed in the LV ejection fraction. Right ventricular (RV) free wall peak systolic circumferential strains were decreased at 6 months (–20.9% ± 2.4% [baseline] vs. –19.1% ± 2.3% [6 months], p = 0.049), whereas RV longitudinal strains and ejection fraction remained unchanged. The LV longitudinal strain was the most reproducible of the 4 peak strain parameters.

Conclusions: The LV longitudinal and circumferential strains measured by CMR decreased during trastuzumab therapy, although their predictive value for later heart failure or association with RV parameters was not determined. These techniques may be a useful means of diagnosing and monitoring trastuzumab-related cardiotoxicity.

Abstract

Background: Trastuzumab, used to treat breast cancer overexpressing human epidermal growth factor receptor 2, may be cardiotoxic. Cardiac magnetic resonance (CMR) imaging with myocardial strain studies has been used to evaluate subclinical biventricular myocardial changes, however, its clinical utility during chemotherapy has not been evaluated.

Methods: The clinical outcomes, CMR and cardiac biomarkers of 9 women aged 62.3 ± 12.6 years with early or locally advanced breast cancer were evaluated at baseline, and at 3, 6 and 12 months after the initiation of trastuzumab.

Results: None of the patients developed heart failure or elevated serum cardiac biomarkers. Global left ventricular (LV) peak systolic longitudinal and circumferential strains were significantly decreased at 6 months (longitudinal strains, –21.1 ± 1.7% [baseline] vs. –19.5 ± 1.0% [6 months], p = 0.039, and circumferential strains, –23.4 ± 1.8% [baseline] vs. –21.6 ± 2.5% [6 months], p = 0.036). These changes were analogous to those observed in the LV ejection fraction. Right ventricular (RV) free wall peak systolic circumferential strains were decreased at 6 months (–20.9% ± 2.4% [baseline] vs. –19.1% ± 2.3% [6 months], p = 0.049), whereas RV longitudinal strains and ejection fraction remained unchanged. The LV longitudinal strain was the most reproducible of the 4 peak strain parameters.

Conclusions: The LV longitudinal and circumferential strains measured by CMR decreased during trastuzumab therapy, although their predictive value for later heart failure or association with RV parameters was not determined. These techniques may be a useful means of diagnosing and monitoring trastuzumab-related cardiotoxicity.

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Keywords

cardiac magnetic resonance; myocardial strain; trastuzumab; breast cancer; cardiotoxicity

About this article
Title

Cardiac magnetic resonance imaging-based myocardial strain study for evaluation of cardiotoxicity in breast cancer patients treated with trastuzumab: A pilot study to evaluate the feasibility of the method

Journal

Cardiology Journal

Issue

Vol 23, No 3 (2016)

Pages

270-280

Published online

2016-05-10

DOI

10.5603/CJ.a2016.0023

Bibliographic record

Cardiol J 2016;23(3):270-280.

Keywords

cardiac magnetic resonance
myocardial strain
trastuzumab
breast cancer
cardiotoxicity

Authors

Shintaro Nakano
Masahiro Takahashi
Fumiko Kimura
Taiki Senoo
Toshiaki Saeki
Shigeto Ueda
Jun Tanno
Takaaki Senbonmatsu
Takatoshi Kasai
Shigeyuki Nishimura

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