Christian P Houbois1, Mark Nolan2, Emily Somerset3, Tamar Shalmon4, Maryam Esmaeilzadeh4, Mariana M Lamacie4, Eitan Amir5, Christine Brezden-Masley6, C Anne Koch7, Yobiga Thevakumaran4, Andrew T Yan8, Thomas H Marwick9, Bernd J Wintersperger1, Paaladinesh Thavendiranathan10. 1. Joint Department of Medical Imaging, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada; Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada. 2. Ted Rogers Program in Cardiotoxicity Prevention, Peter Munk Cardiac Center, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada; Baker Heart and Diabetes Institute, Melbourne, Australia. 3. Rogers Computational Program, Ted Rogers Centre for Heart Research, Peter Munk Cardiac Centre, University Health Network, Toronto, Canada. 4. Ted Rogers Program in Cardiotoxicity Prevention, Peter Munk Cardiac Center, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada. 5. Division of Medical Oncology, Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, Ontario, Canada. 6. Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada. 7. Division of Radiation Oncology, Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, Ontario, Canada. 8. Keenan Research Centre, Li Ka Shing Knowledge Institute, Division of Cardiology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada. 9. Baker Heart and Diabetes Institute, Melbourne, Australia. 10. Joint Department of Medical Imaging, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada; Ted Rogers Program in Cardiotoxicity Prevention, Peter Munk Cardiac Center, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada. Electronic address: dinesh.thavendiranathan@uhn.ca.
Abstract
OBJECTIVES: This study sought to compare the prognostic value of cardiovascular magnetic resonance (CMR) and 2-dimensional echocardiography (2DE) derived left ventricular (LV) strain, volumes, and ejection fraction for cancer therapy-related cardiac dysfunction (CTRCD) in women with early stage breast cancer. BACKGROUND: There are limited comparative data on the association of CMR and 2DE derived strain, volumes, and LVEF with CTRCD. METHODS: A total of 125 prospectively recruited women with HER2+ early stage breast cancer receiving sequential anthracycline/trastuzumab underwent 5 serial CMR and 6 of 2DE studies before and during treatment. CMR LV volumes, left ventricular ejection fraction tagged-CMR, and feature-tracking (FT) derived global systolic longitudinal (GLS) and global circumferential strain (GCS) and 2DE-based LV volumes, function, GLS, and GCS were measured. CTRCD was defined by the cardiac review and evaluation committee criteria. RESULTS: Twenty-eight percent of patients developed CTRCD by CMR and 22% by 2DE. A 15% relative reduction in 2DE-GLS increased the CTRCD odds by 133% at subsequent follow-up, compared with 47%/50% by tagged-CMR GLS/GCS and 87% by FT-GCS. CMR and 2DE-LVEF and indexed left ventricular end-systolic volume (LVESVi) were also associated with subsequent CTRCD. The prognostic threshold change in CMR-left ventricular ejection fraction and FT strain for subsequent CTRCD was similar to the known minimum-detectable difference for these measures, whereas for tagged-CMR strain it was lower than the minimum-detectable difference; for 2DE, only the prognostic threshold for GLS was greater than the minimum-detectable difference. Of all strain methods, 2DE-GLS provided the highest increase in discriminatory value over baseline clinical risk factors for subsequent CTRCD. The combination of 2DE-left ventricular ejection fraction or LVESVi and strain provided greater increase in the area under the curve for subsequent CTRCD over clinical risk factors than CMR left ventricular ejection fraction or LVESVi and strain (18% to 22% vs. 9% to 14%). CONCLUSIONS: In women with HER2+ early stage breast cancer, changes in CMR and 2DE strain, left ventricular ejection fraction, and LVESVi were prognostic for subsequent CTRCD. When LVEF can be measured precisely by CMR, FT strain may function as an additional confirmatory prognostic measure, but with 2DE, GLS is the optimal prognostic measure. (Evaluation of Myocardial Changes During BReast Adenocarcinoma Therapy to Detect Cardiotoxicity Earlier With MRI [EMBRACE-MRI]; NCT02306538).
OBJECTIVES: This study sought to compare the prognostic value of cardiovascular magnetic resonance (CMR) and 2-dimensional echocardiography (2DE) derived left ventricular (LV) strain, volumes, and ejection fraction for cancer therapy-related cardiac dysfunction (CTRCD) in women with early stage breast cancer. BACKGROUND: There are limited comparative data on the association of CMR and 2DE derived strain, volumes, and LVEF with CTRCD. METHODS: A total of 125 prospectively recruited women with HER2+ early stage breast cancer receiving sequential anthracycline/trastuzumab underwent 5 serial CMR and 6 of 2DE studies before and during treatment. CMR LV volumes, left ventricular ejection fraction tagged-CMR, and feature-tracking (FT) derived global systolic longitudinal (GLS) and global circumferential strain (GCS) and 2DE-based LV volumes, function, GLS, and GCS were measured. CTRCD was defined by the cardiac review and evaluation committee criteria. RESULTS: Twenty-eight percent of patients developed CTRCD by CMR and 22% by 2DE. A 15% relative reduction in 2DE-GLS increased the CTRCD odds by 133% at subsequent follow-up, compared with 47%/50% by tagged-CMR GLS/GCS and 87% by FT-GCS. CMR and 2DE-LVEF and indexed left ventricular end-systolic volume (LVESVi) were also associated with subsequent CTRCD. The prognostic threshold change in CMR-left ventricular ejection fraction and FT strain for subsequent CTRCD was similar to the known minimum-detectable difference for these measures, whereas for tagged-CMR strain it was lower than the minimum-detectable difference; for 2DE, only the prognostic threshold for GLS was greater than the minimum-detectable difference. Of all strain methods, 2DE-GLS provided the highest increase in discriminatory value over baseline clinical risk factors for subsequent CTRCD. The combination of 2DE-left ventricular ejection fraction or LVESVi and strain provided greater increase in the area under the curve for subsequent CTRCD over clinical risk factors than CMR left ventricular ejection fraction or LVESVi and strain (18% to 22% vs. 9% to 14%). CONCLUSIONS: In women with HER2+ early stage breast cancer, changes in CMR and 2DE strain, left ventricular ejection fraction, and LVESVi were prognostic for subsequent CTRCD. When LVEF can be measured precisely by CMR, FT strain may function as an additional confirmatory prognostic measure, but with 2DE, GLS is the optimal prognostic measure. (Evaluation of Myocardial Changes During BReast Adenocarcinoma Therapy to Detect Cardiotoxicity Earlier With MRI [EMBRACE-MRI]; NCT02306538).
Authors: Srilakshmi Vallabhaneni; Kathleen W Zhang; Jose A Alvarez-Cardona; Joshua D Mitchell; Henning Steen; Pamela K Woodard; Daniel J Lenihan Journal: Int J Cardiovasc Imaging Date: 2021-05-12 Impact factor: 2.357
Authors: Nidaa Mikail; Alexia Rossi; Susan Bengs; Ahmed Haider; Barbara E Stähli; Angela Portmann; Alessio Imperiale; Valerie Treyer; Alexander Meisel; Aju P Pazhenkottil; Michael Messerli; Vera Regitz-Zagrosek; Philipp A Kaufmann; Ronny R Buechel; Cathérine Gebhard Journal: Eur J Nucl Med Mol Imaging Date: 2022-08-17 Impact factor: 10.057
Authors: Joerg Herrmann; Daniel Lenihan; Saro Armenian; Ana Barac; Anne Blaes; Daniela Cardinale; Joseph Carver; Susan Dent; Bonnie Ky; Alexander R Lyon; Teresa López-Fernández; Michael G Fradley; Sarju Ganatra; Giuseppe Curigliano; Joshua D Mitchell; Giorgio Minotti; Ninian N Lang; Jennifer E Liu; Tomas G Neilan; Anju Nohria; Rupal O'Quinn; Iskra Pusic; Charles Porter; Kerry L Reynolds; Kathryn J Ruddy; Paaladinesh Thavendiranathan; Peter Valent Journal: Eur Heart J Date: 2022-01-31 Impact factor: 35.855
Authors: Daming Shen; Ashitha Pathrose; Roberto Sarnari; Allison Blake; Haben Berhane; Justin J Baraboo; James C Carr; Michael Markl; Daniel Kim Journal: NMR Biomed Date: 2021-09-02 Impact factor: 4.044