Abstract 17007: Cardiac Magnetic Resonance Assessment of Right Ventricular Remodeling After Anthracycline Therapy
Introduction: There are limited data characterizing the effect of anthracyclines on right ventricular (RV) structure and function. Hypothesis: The goal of this study was to test the effect of anthracyclines on RV myocardial remodeling using cardiac magnetic resonance (CMR). Methods: This was a prospective CMR and serum biomarker study of 27 women with breast cancer (BC) (51.8±8.9 years) who underwent a CMR prior, and up to 3-times after anthracycline therapy (240 mg/m 2 ). The primary measure of interest was the RV extracellular volume (ECV) and cardiomyocyte mass index (1-ECV). Additional measures of interest were the left ventricular (LV) ECV, and the LV and RV mass. Biomarkers included high-sensitive troponin T, and creatinine-kinase MB isoenzyme (CKMB). Results: Before anthracyclines, all subjects had normal LV ejection fraction (EF) (69.4±3.6%) and RVEF (55.6±9%). At 351-700 days after anthracyclines, the LVEF and LV mass index declined to 58±6% (P<0.001) and 36±6g/m 2 (P<0.001). Similarly, the RVEF and RV mass index also decreased, reaching 46.3±6.8% at (222-350] days (P<0.001) and 8.13±2g/m 2 at (350-700] days (P<0.001) after anthracycline, respectively (Figure 1). At (350-700] days after anthracycline, both LV and RV ECV increased by 0.037 to 0.36±0.04 (P=0.004) and by 0.12 to 0.40±0.07 (P<0.001), respectively (Figure 2). In parallel, both the LV and RV cardiomyocyte mass also decreased after anthracyclines (Figure 2). Conclusions: In a prospective observational study among women with breast cancer, anthracyclines were associated with a decrease in the RV EF, an increase in the RV ECV and a decrease in the RV cardiomyocyte mass.