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Assessment of echocardiography and biomarkers for the extended prediction of cardiotoxicity in patients treated with anthracyclines, taxanes, and trastuzumab.

Publication ,  Journal Article
Sawaya, H; Sebag, IA; Plana, JC; Januzzi, JL; Ky, B; Tan, TC; Cohen, V; Banchs, J; Carver, JR; Wiegers, SE; Martin, RP; Picard, MH; Kuter, I ...
Published in: Circ Cardiovasc Imaging
September 1, 2012

BACKGROUND: Because cancer patients survive longer, the impact of cardiotoxicity associated with the use of cancer treatments escalates. The present study investigates whether early alterations of myocardial strain and blood biomarkers predict incident cardiotoxicity in patients with breast cancer during treatment with anthracyclines, taxanes, and trastuzumab. METHODS AND RESULTS: Eighty-one women with newly diagnosed human epidermal growth factor receptor 2-positive breast cancer, treated with anthracyclines followed by taxanes and trastuzumab were enrolled to be evaluated every 3 months during their cancer therapy (total of 15 months) using echocardiograms and blood samples. Left ventricular ejection fraction, peak systolic longitudinal, radial, and circumferential myocardial strain were calculated. Ultrasensitive troponin I, N-terminal pro-B-type natriuretic peptide, and the interleukin family member (ST2) were also measured. Left ventricular ejection fraction decreased (64 ± 5% to 59 ± 6%; P<0.0001) over 15 months. Twenty-six patients (32%, [22%-43%]) developed cardiotoxicity as defined by the Cardiac Review and Evaluation Committee Reviewing Trastuzumab; of these patients, 5 (6%, [2%-14%]) had symptoms of heart failure. Peak systolic longitudinal myocardial strain and ultrasensitive troponin I measured at the completion of anthracyclines treatment predicted the subsequent development of cardiotoxicity; no significant associations were observed for left ventricular ejection fraction, N-terminal pro-B-type natriuretic peptide, and ST2. Longitudinal strain was <19% in all patients who later developed heart failure. CONCLUSIONS: In patients with breast cancer treated with anthracyclines, taxanes, and trastuzumab, systolic longitudinal myocardial strain and ultrasensitive troponin I measured at the completion of anthracyclines therapy are useful in the prediction of subsequent cardiotoxicity and may help guide treatment to avoid cardiac side-effects.

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Published In

Circ Cardiovasc Imaging

DOI

EISSN

1942-0080

Publication Date

September 1, 2012

Volume

5

Issue

5

Start / End Page

596 / 603

Location

United States

Related Subject Headings

  • Ventricular Function, Left
  • Troponin I
  • Trastuzumab
  • Time Factors
  • Taxoids
  • Stroke Volume
  • Risk Factors
  • Risk Assessment
  • Receptors, Cell Surface
  • Prospective Studies
 

Citation

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Sawaya, H., Sebag, I. A., Plana, J. C., Januzzi, J. L., Ky, B., Tan, T. C., … Scherrer-Crosbie, M. (2012). Assessment of echocardiography and biomarkers for the extended prediction of cardiotoxicity in patients treated with anthracyclines, taxanes, and trastuzumab. Circ Cardiovasc Imaging, 5(5), 596–603. https://doi.org/10.1161/CIRCIMAGING.112.973321
Sawaya, Heloisa, Igal A. Sebag, Juan Carlos Plana, James L. Januzzi, Bonnie Ky, Timothy C. Tan, Victor Cohen, et al. “Assessment of echocardiography and biomarkers for the extended prediction of cardiotoxicity in patients treated with anthracyclines, taxanes, and trastuzumab.Circ Cardiovasc Imaging 5, no. 5 (September 1, 2012): 596–603. https://doi.org/10.1161/CIRCIMAGING.112.973321.
Sawaya H, Sebag IA, Plana JC, Januzzi JL, Ky B, Tan TC, et al. Assessment of echocardiography and biomarkers for the extended prediction of cardiotoxicity in patients treated with anthracyclines, taxanes, and trastuzumab. Circ Cardiovasc Imaging. 2012 Sep 1;5(5):596–603.
Sawaya, Heloisa, et al. “Assessment of echocardiography and biomarkers for the extended prediction of cardiotoxicity in patients treated with anthracyclines, taxanes, and trastuzumab.Circ Cardiovasc Imaging, vol. 5, no. 5, Sept. 2012, pp. 596–603. Pubmed, doi:10.1161/CIRCIMAGING.112.973321.
Sawaya H, Sebag IA, Plana JC, Januzzi JL, Ky B, Tan TC, Cohen V, Banchs J, Carver JR, Wiegers SE, Martin RP, Picard MH, Gerszten RE, Halpern EF, Passeri J, Kuter I, Scherrer-Crosbie M. Assessment of echocardiography and biomarkers for the extended prediction of cardiotoxicity in patients treated with anthracyclines, taxanes, and trastuzumab. Circ Cardiovasc Imaging. 2012 Sep 1;5(5):596–603.

Published In

Circ Cardiovasc Imaging

DOI

EISSN

1942-0080

Publication Date

September 1, 2012

Volume

5

Issue

5

Start / End Page

596 / 603

Location

United States

Related Subject Headings

  • Ventricular Function, Left
  • Troponin I
  • Trastuzumab
  • Time Factors
  • Taxoids
  • Stroke Volume
  • Risk Factors
  • Risk Assessment
  • Receptors, Cell Surface
  • Prospective Studies