Left ventricular global longitudinal strain is worse in BRCA mutation positive breast cancer patients prior to cancer treatment and premature menopause.

BRCA Breast cancer Cardiomyopathy Cardiotoxicity LV-GLS Oophorectomy Strain

Journal

Breast cancer research and treatment
ISSN: 1573-7217
Titre abrégé: Breast Cancer Res Treat
Pays: Netherlands
ID NLM: 8111104

Informations de publication

Date de publication:
08 May 2024
Historique:
received: 04 12 2023
accepted: 10 04 2024
medline: 8 5 2024
pubmed: 8 5 2024
entrez: 8 5 2024
Statut: aheadofprint

Résumé

Breast cancer patients with mutations in human tumor suppressor genes BRCA1 and BRCA2 are at higher risk of cardiovascular disease (CVD) than the general population, as they are frequently exposed to cardiotoxic chemotherapy, anti-estrogen therapy, radiation, and/or oophorectomy for cancer-related treatment and prophylaxis. Animal and cell culture models suggest that BRCA mutations may play an independent role in heart failure. We sought to evaluate cardiac structure and function in female BRCA1 and BRCA2 mutation carriers with breast cancer compared to BRCA wildtype women with breast cancer. We performed a 1:2 age- and hypertension-matched retrospective cohort study comparing BRCA1 and BRCA2 mutation carriers (n = 38) versus BRCA wildtype controls (n = 76) with a new diagnosis of breast cancer. Echocardiographic data were obtained within 6 months of breast cancer diagnosis and prior to chemotherapy, anti-estrogen therapy, radiation, or oophorectomy. Left ventricular global longitudinal strain (LV-GLS), a highly sensitive marker of LV function, was measured using QLab 15 (Philips Healthcare). In the total cohort of 114 patients with a new diagnosis of breast cancer, the median age was 45 ± 11 years and the prevalence of hypertension was 8%. There were no differences in traditional cardiovascular disease risk factors between cases and controls. BRCA carriers had lower LV-GLS (- 18.1% ± 4.7% vs. - 20.1% ± 3.8%, p = 0.02) and greater right atrial area (12.9 cm In women with newly diagnosed breast cancer and prior to treatment, LV-GLS was worse in BRCA1 and BRCA2 mutation carriers compared to those with BRCA wildtype. These findings suggest that BRCA mutations may be associated with subtle changes in cardiac function. Whether differences in GLS translate to increased cardiovascular risk in women with BRCA mutations needs to be further characterized.

Identifiants

pubmed: 38717528
doi: 10.1007/s10549-024-07344-4
pii: 10.1007/s10549-024-07344-4
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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Auteurs

Billy Lin (B)

Division of Cardiology, University of California Riverside, Riverside, CA, USA.
Department of Internal Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.

Alexis LeVee (A)

Department of Internal Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, CA, USA.

Louie Cao (L)

Department of Internal Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.

Reva Basho (R)

Department of Internal Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Ellison Institute of Technology, Los Angeles, CA, USA.

Balaji Tamarappoo (B)

Department of Cardiology, University of Arizona School of Medicine, Phoenix, AZ, USA.

Janet Wei (J)

Barbra Streisand Women's Heart Center, Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, CA, USA.

Chrisandra Shufelt (C)

Mayo Clinic Women's Health and Division of General Internal Medicine, Jacksonville, FL, USA. Shufelt.Chrisandra@mayo.edu.

Classifications MeSH