Abstract 16815: Assessment of Myocardial Strain by Varying Chemotherapy Regimens in Breast Cancer Patients
Background: Serial assessment of left ventricular (LV) function is recommended to detect cardiac toxicity in women with breast cancer who are undergoing treatment with anthracyclines and/or trastuzumab-based chemotherapies. We sought to study the changes in myocardial strain with various chemotherapy regimens that have been known to cause cardiac toxicity.
Methods: Eighty Six women with normal left ventricular function who were undergoing therapy for breast cancer with doxorubicin and/or trastuzumab and underwent echocardiograms at our institution between October 2012 and May of 2013 were retrospectively examined. All patients who underwent radiation therapy were excluded. Left ventricular ejection fraction (LVEF), global longitudinal strain (GLS), and circumferential strain (CS) were measured.
Results: In comparison to thirty five patients who received a baseline echocardiogram, prior to initiation of therapy, the LVEF was lower in patients receiving doxorubicin alone (61% ± 4% to 55% ± 15%, p=0.03) and both doxorubicin and trastuzumab (61% ± 4% to 53% ± 9%, p<0.01). GLS was lower in patients who received both doxorubicin and trastuzumab (-19.4 ± 2.6 to -16.7 ± 2.6, p<0.01). CS was lower in patients who received both doxorubicin and trastuzumab (-16.9 ± 4.5 to -13.0 ± 6.2, p= 0.03). There were no significant changes in strain in the trastuzumab only group, even when examined by trastuzumab cycle number.
Conclusions: Longitudinal and circumferential strain can be used to differentiate the contribution of various chemotherapies to the development of cardiotoxicity. It remains to be determined whether these changes in myocardial strain are related to clinical outcome in our patient cohort.
- © 2013 by American Heart Association, Inc.