scholarly journals Association between Left Ventricular Global Longitudinal Strain and Six Minute Walk Test Before and After Chemotherapy with Anthracycline in Breast Cancer Patients

2018 ◽  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Walk Test ◽  
Breast Cancer Patients ◽  
Six Minute Walk Test ◽  
Before And After ◽  
Minute Walk

scholarly journals Clinical outcomes of chemotherapy-induced subclinical left ventricular systolic dysfunction among breast cancer patients detected using echocardiographic global longitudinal strain

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J.G.G Manaloto ◽  
M.K Cruz-Tan ◽  
R.H Tiongco ◽  
R.M Jimenez ◽  
G.H Cornelio
Keyword(s):  
Breast Cancer ◽  
Heart Failure ◽  
Cancer Patients ◽  
Clinical Outcomes ◽  
Longitudinal Strain ◽  
Systolic Dysfunction ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Breast Cancer Patients ◽  
All Cause Mortality

Abstract Background Echocardiographic global longitudinal strain (GLS) detects early subclinical left ventricular (LV) systolic dysfunction, before the occurrence of a decreased LV ejection fraction. However, our local data is lacking to determine its impact to clinical outcomes. Purpose The study aimed to determine the clinical outcomes of breast cancer patients who developed subclinical LV systolic dysfunction as determined by an abnormal GLS post-chemotherapy. Methods This retrospective cohort study included 99 breast cancer patients who underwent anthracycline and/or HER-2 receptor inhibitor chemotherapy from January 1, 2016 to December 31, 2018 in a single tertiary hospital. Clinical outcomes of all-cause mortality and overt heart failure were compared between those with normal and abnormal GLS post-chemotherapy. Results The prevalence of subclinical LV systolic dysfunction was 18%, wherein 28% of them had subsequent overt heart failure, and 33% expired. Abnormal GLS occurred at a mean 3.5 months (range 1–8 months) after initiation of chemotherapy and at 8 months (range 6–10 months) after the entire chemotherapy sessions. Development into heart failure was observed at a mean of 6.7 months (range 4–12 months) after occurrence of abnormal GLS. Hypertension and age >56 years were determined to be risk factors. Beta-blockers, ACE inhibitors and statins seemed to be non-protective in our cohort. Abnormalities in GLS were observed at a mean dose of 260 mg/m2 of epirubicin, lower than the dose described as high risk in the literature (600 mg/m2 for epirubicin). In trastuzumab, abnormal GLS occurred as early as 1 month after initiation. LVEF had no significant change within 2 months (p=0.56), but was significantly lower within 12 months post-chemotherapy (p=0.005). All-cause mortality was 3-fold higher (RR=3.00; p=0.02), and the risk to develop heart failure was 4 times higher (RR=4.74; p=0.008) in those with abnormal GLS. Conclusion The development of abnormal GLS post-chemotherapy was associated with subsequent development of overt heart failure and increased all-cause mortality. Abnormal GLS occurred at lower doses of epirubicin and as early as 1 month after initiating trastuzumab. We recommend echo surveillance with GLS monitoring beginning >250 mg/m2 with anthracycline (and after 1–2 months of Trastuzumab), and to repeat at 1–2 months and 9–12 months post-chemotherapy. Funding Acknowledgement Type of funding source: None

Immediate evaluation of global longitudinal strain at initiation of trastuzumab treatment in breast cancer patients

2021 ◽  
Author(s):  
Ann Banke ◽  
Morten Schou ◽  
Marianne Ewertz ◽  
Jordi Dahl ◽  
Peter Hartmund Frederiksen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Breast Cancer Patients ◽  
Trastuzumab Treatment

Segmental Left Ventricular Longitudinal Strain Changes Following Tangential Radiation in Left-Sided Breast Cancer Patients

2019 ◽  
Vol 105 (1) ◽  
pp. E46-E47
Author(s):  
S.C. Tang ◽  
S. Trivedi ◽  
J. Otton ◽  
G. Liney ◽  
G. Delaney ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Longitudinal Strain ◽  
Left Ventricular ◽  
Breast Cancer Patients

scholarly journals 6135Left atrial global longitudinal strain as a new predictor of cardiotoxicity in breast cancer patients

2018 ◽  
Vol 39 (suppl_1) ◽  
Author(s):  
H Park ◽  
M Kim ◽  
H K Jeong ◽  
K H Kim ◽  
H Y Kim ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Breast Cancer Patients

Persistent Reductions in Global Longitudinal Strain Late After Radiotherapy in Chemotherapy Naive Left-Sided Breast Cancer Patients

2018 ◽  
Vol 27 ◽  
pp. S263
Author(s):  
S. Trivedi ◽  
P. Choudhary ◽  
Q. Lo ◽  
H. Sritharan ◽  
V. Batumalai ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Breast Cancer Patients

scholarly journals Fully automated and comprehensive MRI-based left-ventricular contractility analysis in post-chemotherapy breast cancer patients

2020 ◽  
Vol 93 (1105) ◽  
pp. 20190289
Author(s):  
Julia Kar ◽  
Michael V. Cohen ◽  
Samuel A. McQuiston ◽  
Maria S. Figarola ◽  
Christopher M. Malozzi
Keyword(s):  
Breast Cancer ◽  
Steady State ◽  
Cancer Patients ◽  
Healthy Subjects ◽  
Longitudinal Strain ◽  
Steady State Free Precession ◽  
Left Ventricular ◽  
Free Precession ◽  
Breast Cancer Patients ◽  
Basal Diameter

Objective: This study investigated the occurrence of cardiotoxicity-related left-ventricular (LV) contractile dysfunction in breast cancer patients following treatment with antineoplastic chemotherapy agents. Methods: A validated and automated MRI-based LV contractility analysis tool consisting of quantization-based boundary detection, unwrapping of image phases and the meshfree Radial Point Interpolation Method was used toward measuring LV chamber quantifications (LVCQ), three-dimensional strains and torsions in patients and healthy subjects. Data were acquired with the Displacement Encoding with Stimulated Echoes (DENSE) sequence on 21 female patients and 21 age-matched healthy females. Estimates of patient LVCQs from DENSE acquisitions were validated in comparison to similar steady-state free precession measurements and their strain results validated via Bland–Altman interobserver agreements. The occurrence of LV abnormalities was investigated via significant differences in contractility measurements (LVCQs, strains and torsions) between patients and healthy subjects. Results: Repeated measures analysis showed similarities between LVCQ measurements from DENSE and steady-state free precession, including cardiac output (4.7 ± 0.4 L, 4.6 ± 0.4 L, p = 0.8), and LV ejection fractions (59±6%, 58±5%, p = 0.2). Differences found between patients and healthy subjects included enlarged basal diameter (5.0 ± 0.5 cm vs 4.4 ± 0.5 cm, p < 0.01), apical torsion (6.0 ± 1.1° vs 9.7 ± 1.4°, p < 0.001) and global longitudinal strain (−0.15 ± 0.02 vs. -0.21 ± 0.04, p < 0.001), but not LV ejection fraction (59±6% vs. 63±6%, p = 0.1). Conclusion: The results from the statistical analysis reveal the possibility of LV abnormalities in the post-chemotherapy patients via enlarged basal diameter and reduced longitudinal strain and torsion, in comparison to healthy subjects. Advances in knowledge: This study shows that subclinical LV abnormalities in post-chemotherapy breast cancer patients can be detected with an automated technique for the comprehensive analysis of contractile parameters.

scholarly journals Right ventricular dysfunction parallels left ventricular functional involvement in women with breast cancer experiencing subclinical cardiotoxicity

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
C Santoro ◽  
R Soloperto ◽  
O Casciano ◽  
R Esposito ◽  
M Lembo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Heart Failure ◽  
Cancer Therapy ◽  
Right Ventricular ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Breast Cancer Patients ◽  
Longitudinal Function ◽  
Oncologic Patients

Abstract Funding Acknowledgements Type of funding sources: None. Background Cancer therapy related cardiac toxicity disease (CRCTD) of the left ventricle (LV)can influence the outcome of oncologic patients. Little is known on CRCTD related right ventricular (RV)dysfunction even though RV involvement has been proven to be a remarkable prognosticator in heart failure. Purpose To analyse parallel changes in LV and RV function occurring during the course of cancer therapy in women affected by breast cancer by using both standard and speckle tracking echocardiography. Methods Fifty Her-2 positive breast cancer women (age = 53.6 ± 11.7 years) underwent sequential cancer therapy protocol including anthracycline (ANT) epirubicine + cyclophosphamide (4 cycles) followed by a total amount of 18 cycles with trastuzumab (TRZ) + paclitaxel. A complete echo-Doppler exam, including LV and RV global longitudinal strain (GLS)as well as RV septal and free wall longitudinal strain (SLS and FWLS respectively) assessment, was performed at baseline, after ANT end and after TRZ completion. Patients with overt heart failure and LV ejection fraction &lt; 50%, coronary artery disease,atrial fibrillation, hemodinamically significant valve disease and inadequate echo were excluded. Overt CRCTD was defined according guidelines and both subclinical LV and RV CRCTD as a LV and RV GLS drop from baseline &gt;15%. Results None of the patients experienced overt CTCRD but 6 patients (14%) showed subclinical LV dysfunction and 33 (66%) had a significant drop of RV longitudinal function.The comparison of standard echo-Doppler exam at baseline and after ANT and TRZ completion did not show significant changes of LV and RV systolic and diastolic parameters. Conversely, a progressive significant reduction of RV GLS (p &lt; 0.002 after TRZ), SLS and FWLS and, with a lower extent, of LV GLS (p &lt; 0.02 after TRZ) was observed after ANT and TRZ completion (Figure). Percentage reduction in RV GLS (DRV GLS) from baseline to ANT end correlated with LV GLS both at EC end (r=-0.40, p = 0.006) and after TRZ completion (r=-0.62, p &lt; 0.0001). Conclusions Detrimental cardiac effects of cancer therapy involve both LV and RV systolic longitudinal function. Progressive RV dysfunction is evident through ANT and TRZ treatment. Early RV dysfunction parallels LV involvement and predicts subsequent LV subclinical dysfunction. A comprehensive LV and RV longitudinal function assessment might better predict the onset of CRCTD in breast cancer patients. Abstract Figure.

scholarly journals Electromechanical changes of the myocardium after anthracycline chemotherapy

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
B Ozbay ◽  
H Kemal ◽  
E Simsek ◽  
B Cakar ◽  
O Yavuzgil
Keyword(s):  
Breast Cancer ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Radial Strain ◽  
Qt Dispersion ◽  
Breast Cancer Patients ◽  
Myocardial Layers ◽  
Before And After ◽  
Pre Treatment ◽  
Change In Mean

Abstract Funding Acknowledgements Type of funding sources: None. Background and objectives The most common side effects of chemotherapeutics in breast cancer is on the cardiovascular system. Global longitudinal strain (GLS) is the only parameter recommended for follow-up in current guidelines with limited evidence. Other strain imaging parameters and electrical changes after chemotherapy is not well studied. It is not known whether electrical or mechanical changes occur initially. The aim of this study is to evaluate repolarization parameters on ECG and mechanical changes together after chemotherapy in breast cancer patients. Subjects and method Consecutive patients who received chemotherapy due to breast cancer were included. Strain echocardiography and ECGs were performed pre-treatment (T0) and 3rd month after chemotherapy (T2). Additionally, just in three hours of first dose of chemotherapy (T1) another ECG was performed.  QT and QT correction for heart rate (QTc), QT dispersion (QT disp) and QTc dispersion (QTc disp), T wave peak to end time (Tpe) and Tpe corrected for QT-QTc measurements were performed (figüre 1 and 2). GLS, longitudinal strain for myocardial layers, circumferential strain (CS), radial strain (RS) and torsion measurements were performed. All mechanical and electrical parameters from different time intervals were compared. Results Thirty-five consecutive patients (35 females, mean age 48.9 ± 11.8 years) who received chemotherapy (mean doxorubicin cumulative dose 415 ± 32 mg/m2) due to breast cancer were included. There was no significant change in mean GLS values before and after treatment (T0 -%18.8 ± 6.82, T1 18.6 ± 3.5 p = 0,863 respectively). However, there was a significant decrease in CS, RS and torsion (T0 -%17,2 ± 3,5, T1-%13 ± 2,84 p &lt;0,001, T0 %45,1 ± 8,3, T1 %35,6 ±10 p &lt;0,001 and T0 %12,1 ± 3.5, T1 %7.7 ± 2.1 p &lt;0,001, respectively). QT, QTc, QTc disp and Tpe, Tpe/QTc parameters were prolonged just after chemotherapy and were still prolonged 3 months after ((QTc: T1 440.01 ± 27.63, T2 468.00 ± 38.98, T3 467.86 ± 35.09), (QTc disp T1 55.48 ± 20.22, T2 78.59 ± 16.15, T3 66.16 ± 14.62), (Tpe (QTc) T1 104 ± 18.52, T2 148.62 ± 19.16, T3 139.77 ± 21.63), (Tpe/QTc T1 0.213 ± 0.05, T2 0.281 ± 0.08, T3 0.258 ± 0.06). Conclusion   Electrical and mechanical functions of the heart could be impaired together acutely even three months after doxorubicin chemotherapy. Cardio toxicity should be evaluated in terms of both electrically and mechanically. Abstract Figure. ECG repolarization parameters

scholarly journals Global Longitudinal Strain Accuracy for Cardiotoxicity Prediction in a Cohort of Breast Cancer Patients During Anthracycline and/or Trastuzumab Treatment

2018 ◽  
Author(s):  
Eliza de Almeida Gripp ◽  
Gabriela Escudini de Oliveira ◽  
Luiz Augusto Feijó ◽  
Marcelo Iorio Garcia ◽  
Sergio Salles Xavier ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Breast Cancer Patients ◽  
Trastuzumab Treatment
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