Abstract 13501: Measures of Three-dimensional Left Ventricular Mechanics Deteriorate Acutely After Cardiotoxic Cancer Therapy
Background: Doxorubicin and trastuzumab are commonly used breast cancer therapies with established cardiotoxic effects. However, the changes in myocardial mechanics with cancer therapy cardiotoxicity remain poorly defined, and noninvasive measures are needed to identify patients at increased risk. Our objective was to define the acute changes in three-dimensional (3D) echocardiography-derived indices of cardiac mechanics in patients receiving these therapies.
Methods: In a prospective, longitudinal cohort of women with breast cancer receiving doxorubicin and/or trastuzumab, we obtained 3D echocardiography images before therapy (baseline) and during therapy at 3 months and 1 year of follow-up. Images were acquired at a minimum of 22 frames per second and analyzed by two readers using a vendor-independent analysis platform (TomTec Cardiac Performance Analyses, Unterschleissheim, Germany). Left ventricular twist, torsion, and principal strain were quantitated semi-automatically using 3D speckle tracking imaging. Standard descriptive statistics were used to summarize these measures over time.
Results: Eighty-seven patients (mean age at baseline 49 years, 65% Caucasian) contributed at least 1 observation to the analysis. At baseline, median twist was 10.96° (interquartile range [IQR] 6.64, 13.59), torsion was 1.41°/cm (IQR 0.86, 1.70), and principal strain was -30.40% (-33.64, -28.55). At 3 months and 1 year, there were consistent declines in twist, torsion, and principal strain as displayed in Table I.
Conclusions: In a prospective cohort of women with breast cancer receiving doxorubicin and/or trastuzumab, left ventricular twist, torsion, and principal strain declined over the first year of therapy. Ongoing research is focused on determining the clinical significance of these changes over time.
Table 1. Longitudinal changes in 3D twist, torsion, and principal strain; summaries presented as median (interquartile range).
Author Disclosures: K.W. Zhang: None. B. French: None. G. Gulati: None. H.K. Narayan: None. A. Bajulaiye: None. C. Zhang: None. D. Hyman: None. B. Ky: None.
- © 2015 by American Heart Association, Inc.