Abstract 19245: Time Trends of Echocardiography Measures of LV Function in a Cohort of Women with Breast Cancer Treated with Anthracyclines, Taxanes and Trastuzumab
Background: The cardiotoxicity that occurs during treatment by anthracyclines and trastuzumab used for cancer therapy is well recognized. However, the time trend of the decrease in cardiac function is unknown. In particular, the decrease in left ventricular ejection fraction (LVEF) seen with trastuzumab is thought to be transient although there is controversy on this reversibility.
Aim: To determine the trends of LVEF, strain and strain rate after treatment by anthracyclines, taxanes and trastuzumab in a cohort of women with breast cancer that had been serially followed during their treatment.
Methods: Follow up echocardiograms (TTEs) were performed in 25 women >18 years of age with first time breast cancer treated with anthracyclines and trastuzumab, 26.4±11.1 months after the end of the cancer treatment. These women had undergone serial TTEs before and during the duration of the treatment (15 months). LVEF was calculated using a modified Simpson’s biplane method. Global peak systolic longitudinal strain and strain rate were calculated by averaging the values of peak systolic strain and strain rate in the basal, mid-wall and apical segments of the 4- and 2- chamber views.
Results: LVEF, strain and strain rate decreased during the study period (p<0.05 for all 3 parameters) and did not improve after 24 months of treatment completion. Of the three parameters, strain appeared to be most sensitive for the detection of cardiac dysfunction since it demonstrated a significant decrease within the 3 first months of treatment.
Conclusion: Impairment in cardiac function from chemotherapy appears to be persistent even at 26.4±11.1 months post treatment suggestive of long term underlying cardiac damage. These results highlight the potential value of echocardiography in detecting sub-acute cardiac pathology and may help guide cardiac treatment in cancer survivors.
- © 2012 by American Heart Association, Inc.