2D-echocardiography vs cardiac MRI strain: a prospective cohort study in patients with HER2-positive breast cancer undergoing trastuzumab

Cardiovascular Ultrasound

Crista Liesting¹  Marcel J. M. Kofflard¹  Jasper J. Brugts²  Eric Boersma²  Mark-David Levin³  Jos J. E. M. Kitzen³  Nathalie I. Bouwer⁴  Marc C. J. Kock⁵ 

[1]Department of Cardiology, Albert Schweitzer Hospital, Dordrecht, The Netherlands

[2]Department of Cardiology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands

[3]Department of Internal Medicine, Albert Schweitzer Hospital, 3300 AK, Dordrecht, The Netherlands

[4]Department of Internal Medicine, Albert Schweitzer Hospital, 3300 AK, Dordrecht, The Netherlands

[5]Department of Cardiology, Albert Schweitzer Hospital, Dordrecht, The Netherlands

[6]Department of Radiology, Albert Schweitzer Hospital, Dordrecht, The Netherlands

关键词: HER2-positive breast cancer;    Trastuzumab;    Cardiac MRI;    Speckle tracking echocardiography;    Strain imaging;   

DOI  :  10.1186/s12947-021-00266-x

来源: Springer

【 摘 要 】

BackgroundWe aimed to study the predictive value of early two-dimensional echocardiography (2DE) speckle tracking (ST) for left ventricular ejection fraction (LVEF) changes during trastuzumab treatment for HER2-positive breast cancer.MethodsHER2-positive breast cancer patients receiving trastuzumab, with or without anthracycline, underwent 2DE-ST at baseline and after 3 and 6 months (m) trastuzumab. Cardiac magnetic resonance (CMR) imaging (with ST) was performed at baseline and 6 m. We studied the correlation between 2DE-ST- and CMR-derived global longitudinal strain (GLS) and global radial strain (GRS) measured at the same time. Additionally, we associated baseline and 3 m 2DE-ST measurements with later CMR-LVEF, and with cardiotoxicity, defined as CMR-LVEF < 45% and/or absolute decline > 10% during trastuzumab.ResultsForty-seven patients were included. Median baseline LVEF was 60.4%. GLS measurements based on 2DE-ST and CMR showed weak correlation (Pearson’s r = 0.33; p = 0.041); GRS measurements were uncorrelated (r = 0.09; p = 0.979). 2DE-LVEF at baseline and 3 m, and 2DE-ST-GLS at 3 m were predictive of CMR-LVEF at 6 m. In contrast, the change in 2DE-ST-GLS at 3 m was predictive of the change in CMR-LVEF at 6 m, whereas the change in 2DE-LVEF was not. Importantly, the 11 patients who developed cardiotoxicity (28%) had larger 2DE-ST-GLS change at 3 m than those who did not (median 5.2%-points versus 1.7%-points; odds ratio for 1% difference change 1.81, 95% confidence interval 1.11–2.93; p = 0.016; explained variance 0.34).ConclusionsCorrelations between 2DE-ST and CMR-derived measurements are weak. Nevertheless, ST-measurements appeared useful to improve the performance of 2DE in predicting LVEF changes after 6 m of trastuzumab treatment.

【 授权许可】

CC BY