2D-echocardiography vs cardiac MRI strain: a prospective cohort study in patients with HER2-positive breast cancer undergoing trastuzumab.
Cardiac MRI
HER2-positive breast cancer
Speckle tracking echocardiography
Strain imaging
Trastuzumab
Journal
Cardiovascular ultrasound
ISSN: 1476-7120
Titre abrégé: Cardiovasc Ultrasound
Pays: England
ID NLM: 101159952
Informations de publication
Date de publication:
09 Nov 2021
09 Nov 2021
Historique:
received:
10
04
2021
accepted:
18
10
2021
entrez:
10
11
2021
pubmed:
11
11
2021
medline:
12
11
2021
Statut:
epublish
Résumé
We aimed to study the predictive value of early two-dimensional echocardiography (2DE) speckle tracking (ST) for left ventricular ejection fraction (LVEF) changes during trastuzumab treatment for HER2-positive breast cancer. HER2-positive breast cancer patients receiving trastuzumab, with or without anthracycline, underwent 2DE-ST at baseline and after 3 and 6 months (m) trastuzumab. Cardiac magnetic resonance (CMR) imaging (with ST) was performed at baseline and 6 m. We studied the correlation between 2DE-ST- and CMR-derived global longitudinal strain (GLS) and global radial strain (GRS) measured at the same time. Additionally, we associated baseline and 3 m 2DE-ST measurements with later CMR-LVEF, and with cardiotoxicity, defined as CMR-LVEF < 45% and/or absolute decline > 10% during trastuzumab. Forty-seven patients were included. Median baseline LVEF was 60.4%. GLS measurements based on 2DE-ST and CMR showed weak correlation (Pearson's r = 0.33; p = 0.041); GRS measurements were uncorrelated (r = 0.09; p = 0.979). 2DE-LVEF at baseline and 3 m, and 2DE-ST-GLS at 3 m were predictive of CMR-LVEF at 6 m. In contrast, the change in 2DE-ST-GLS at 3 m was predictive of the change in CMR-LVEF at 6 m, whereas the change in 2DE-LVEF was not. Importantly, the 11 patients who developed cardiotoxicity (28%) had larger 2DE-ST-GLS change at 3 m than those who did not (median 5.2%-points versus 1.7%-points; odds ratio for 1% difference change 1.81, 95% confidence interval 1.11-2.93; p = 0.016; explained variance 0.34). Correlations between 2DE-ST and CMR-derived measurements are weak. Nevertheless, ST-measurements appeared useful to improve the performance of 2DE in predicting LVEF changes after 6 m of trastuzumab treatment.
Sections du résumé
BACKGROUND
BACKGROUND
We aimed to study the predictive value of early two-dimensional echocardiography (2DE) speckle tracking (ST) for left ventricular ejection fraction (LVEF) changes during trastuzumab treatment for HER2-positive breast cancer.
METHODS
METHODS
HER2-positive breast cancer patients receiving trastuzumab, with or without anthracycline, underwent 2DE-ST at baseline and after 3 and 6 months (m) trastuzumab. Cardiac magnetic resonance (CMR) imaging (with ST) was performed at baseline and 6 m. We studied the correlation between 2DE-ST- and CMR-derived global longitudinal strain (GLS) and global radial strain (GRS) measured at the same time. Additionally, we associated baseline and 3 m 2DE-ST measurements with later CMR-LVEF, and with cardiotoxicity, defined as CMR-LVEF < 45% and/or absolute decline > 10% during trastuzumab.
RESULTS
RESULTS
Forty-seven patients were included. Median baseline LVEF was 60.4%. GLS measurements based on 2DE-ST and CMR showed weak correlation (Pearson's r = 0.33; p = 0.041); GRS measurements were uncorrelated (r = 0.09; p = 0.979). 2DE-LVEF at baseline and 3 m, and 2DE-ST-GLS at 3 m were predictive of CMR-LVEF at 6 m. In contrast, the change in 2DE-ST-GLS at 3 m was predictive of the change in CMR-LVEF at 6 m, whereas the change in 2DE-LVEF was not. Importantly, the 11 patients who developed cardiotoxicity (28%) had larger 2DE-ST-GLS change at 3 m than those who did not (median 5.2%-points versus 1.7%-points; odds ratio for 1% difference change 1.81, 95% confidence interval 1.11-2.93; p = 0.016; explained variance 0.34).
CONCLUSIONS
CONCLUSIONS
Correlations between 2DE-ST and CMR-derived measurements are weak. Nevertheless, ST-measurements appeared useful to improve the performance of 2DE in predicting LVEF changes after 6 m of trastuzumab treatment.
Identifiants
pubmed: 34753503
doi: 10.1186/s12947-021-00266-x
pii: 10.1186/s12947-021-00266-x
pmc: PMC8576921
doi:
Substances chimiques
Trastuzumab
P188ANX8CK
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
35Informations de copyright
© 2021. The Author(s).
Références
JAMA Netw Open. 2018 Aug 3;1(4):e181456
pubmed: 30646130
Circ Cardiovasc Imaging. 2017 Nov;10(11):
pubmed: 29138230
Breast Cancer Res Treat. 2021 Apr;186(3):851-862
pubmed: 33394273
J Cardiovasc Magn Reson. 2019 Aug 8;21(1):46
pubmed: 31391036
J Clin Oncol. 2012 Aug 10;30(23):2876-84
pubmed: 22802310
Sci Rep. 2019 Aug 5;9(1):11296
pubmed: 31383914
J Am Soc Echocardiogr. 2018 Sep;31(9):1021-1033.e1
pubmed: 29936007
J Am Coll Cardiol. 2021 Feb 2;77(4):392-401
pubmed: 33220426
Elife. 2019 Oct 09;8:
pubmed: 31596231
Circ Cardiovasc Imaging. 2012 Sep 1;5(5):596-603
pubmed: 22744937
Eur Heart J. 2000 Aug;21(16):1387-96
pubmed: 10952828
J Am Soc Echocardiogr. 2013 May;26(5):493-8
pubmed: 23562088
J Am Coll Cardiol. 2013 Jan 8;61(1):77-84
pubmed: 23199515
JAMA Cardiol. 2019 Oct 1;4(10):1007-1018
pubmed: 31433450
J Am Coll Cardiol. 2010 Jan 19;55(3):213-20
pubmed: 20117401
J Cardiovasc Magn Reson. 2016 Aug 26;18(1):51
pubmed: 27561421
J Am Soc Echocardiogr. 2011 Mar;24(3):277-313
pubmed: 21338865
J Clin Oncol. 2014 Jul 1;32(19):2078-99
pubmed: 24799465
Medicine (Baltimore). 2016 Nov;95(44):e5195
pubmed: 27858859
Br J Cancer. 2009 Mar 10;100(5):684-92
pubmed: 19259090
Am J Cardiol. 2011 May 1;107(9):1375-80
pubmed: 21371685
Ann Oncol. 2020 Feb;31(2):171-190
pubmed: 31959335
Breast. 2020 Aug;52:33-44
pubmed: 32361151
J Am Soc Echocardiogr. 2015 May;28(5):587-96
pubmed: 25577185
Am J Cardiol. 2006 Jun 1;97(11):1661-6
pubmed: 16728234
Rev Port Cardiol. 2017 Jan;36(1):9-15
pubmed: 27955938
J Cardiovasc Magn Reson. 2017 Sep 1;19(1):66
pubmed: 28863780
Eur Heart J Cardiovasc Imaging. 2014 Oct;15(10):1063-93
pubmed: 25239940
Eur J Echocardiogr. 2009 Jan;10(1):82-8
pubmed: 18490270
J Am Soc Echocardiogr. 2015 Oct;28(10):1171-1181, e2
pubmed: 26209911
J Am Coll Cardiol. 2019 Jun 11;73(22):2859-2868
pubmed: 31171092
Acta Cardiol Sin. 2016 Sep;32(5):560-564
pubmed: 27713604
J Am Soc Echocardiogr. 2008 Dec;21(12):1318-25
pubmed: 19041575
Eur Heart J Cardiovasc Imaging. 2016 May;17(5):525-32
pubmed: 26377901
J Am Soc Echocardiogr. 2014 Mar;27(3):292-301
pubmed: 24440110
Breast Cancer Res Treat. 2019 Jun;175(3):595-603
pubmed: 30852761