Negareh Mousavi1, Timothy C Tan1, Mohammed Ali1, Elkan F Halpern2, Lin Wang1, Marielle Scherrer-Crosbie3. 1. Cardiac Ultrasound Laboratory, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA. 2. Institute for Technology Assessment, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. 3. Cardiac Ultrasound Laboratory, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA marielle@crosbie.com.
Abstract
AIMS: The aim of this study was to assess whether baseline echocardiographic measures of left ventricular (LV) size and function predict the development of symptomatic heart failure or cardiac death (major adverse cardiac events, MACE) in patients treated with anthracyclines who have a pre-chemotherapy left ventricular ejection fraction (LVEF) between 50 and 59%. METHODS AND RESULTS: Patients with an LVEF between 50 and 59% before anthracyclines were selected. In these patients, LV volumes, LVEF, and peak longitudinal strain (GLS) were measured. Individuals were followed for MACE and all-cause mortality over a median of 659 days (range: 3-3704 days). Of 2234 patients undergoing echocardiography for pre-anthracycline assessment, 158 (7%) had a resting ejection fraction of 50-59%. Their average LV end-diastolic volume (LVEDV) was 101 ± 22 mL, LVEF was 54 ± 3%, and global longitudinal strain (GLS) was -17.7 ± 2.6%. Twelve patients experienced a MACE (congestive heart failure) at a median of 173 days (range: 15-530). Age, diabetes, previous coronary artery disease, LVEDV, indexed LVEDV, LVESV, indexed LVESV, and GLS were all predictive of MACE (P = 0.012, 0.039, 0.0029, 0.012, and 0.0065 for LVEDV, LVEDVI, LVESV, LVESVI, and GLS, respectively). Indexed LVEDV and GLS remained predictive of MACE when adjusted for age. Age and GLS were also predictive of overall mortality (P < 0.0001 and 0.0105, respectively). CONCLUSION: In patients treated with anthracyclines with an LVEF of 50-59%, both baseline EDV and GLS predict the occurrence of MACE. These parameters may help target patients who could benefit from closer cardiac surveillance and earlier initiation of cardioprotective medical therapy. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: The aim of this study was to assess whether baseline echocardiographic measures of left ventricular (LV) size and function predict the development of symptomatic heart failure or cardiac death (major adverse cardiac events, MACE) in patients treated with anthracyclines who have a pre-chemotherapy left ventricular ejection fraction (LVEF) between 50 and 59%. METHODS AND RESULTS:Patients with an LVEF between 50 and 59% before anthracyclines were selected. In these patients, LV volumes, LVEF, and peak longitudinal strain (GLS) were measured. Individuals were followed for MACE and all-cause mortality over a median of 659 days (range: 3-3704 days). Of 2234 patients undergoing echocardiography for pre-anthracycline assessment, 158 (7%) had a resting ejection fraction of 50-59%. Their average LV end-diastolic volume (LVEDV) was 101 ± 22 mL, LVEF was 54 ± 3%, and global longitudinal strain (GLS) was -17.7 ± 2.6%. Twelve patients experienced a MACE (congestive heart failure) at a median of 173 days (range: 15-530). Age, diabetes, previous coronary artery disease, LVEDV, indexed LVEDV, LVESV, indexed LVESV, and GLS were all predictive of MACE (P = 0.012, 0.039, 0.0029, 0.012, and 0.0065 for LVEDV, LVEDVI, LVESV, LVESVI, and GLS, respectively). Indexed LVEDV and GLS remained predictive of MACE when adjusted for age. Age and GLS were also predictive of overall mortality (P < 0.0001 and 0.0105, respectively). CONCLUSION: In patients treated with anthracyclines with an LVEF of 50-59%, both baseline EDV and GLS predict the occurrence of MACE. These parameters may help target patients who could benefit from closer cardiac surveillance and earlier initiation of cardioprotective medical therapy. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Wael A AlJaroudi; Andrew J Einstein; Farooq A Chaudhry; Steven G Lloyd; Fadi G Hage Journal: J Nucl Cardiol Date: 2015-02-20 Impact factor: 5.952
Authors: Anita Boyd; Paul Stoodley; David Richards; Rina Hui; Paul Harnett; Kim Vo; Tom Marwick; Liza Thomas Journal: PLoS One Date: 2017-04-13 Impact factor: 3.240