Serial changes of layer-specific myocardial function according to chemotherapy regimen in patients with breast cancer
- Abstract
- AIMS: Chemotherapy-induced cardiotoxicity (CIC) is a significant complication, meanwhile myocardial damage might differ depending on chemotherapy agents and their timing. The aim of this study was to evaluate serial changes of layer-specific myocardial function in patients with breast cancer and their differences by the development time of CIC and chemotherapy agent. METHODS AND RESULTS: A total of 105 consecutive patients with breast cancer (age: 52.3 ± 9.3 years) were enrolled. Chemotherapy-induced cardiotoxicity occurred in 20 (19%) patients during 6 months. Endocardial and midmyocardial functions decreased in patients with or without CIC, with patients with CIC showing greater decreases during follow-up. Global longitudinal strain (GLS) change at 3 months was the most sensitive parameter to detect CIC. When new development of CIC was analysed at 6 months, GLS was reduced earlier than the decrease of left ventricular ejection fraction. In patients with CIC who were treated with anthracycline-based regimen for 3 months, endocardial GLS markedly decreased at 3 months and continued to decrease until 6 months. Patients with CIC who received trastuzumab therapy after anthracycline therapy showed further reduction in endocardial GLS at the 6-month follow-up, which was not shown in patients with CIC who received taxane therapy subsequently. CONCLUSION: Myocardial function assessed by strain decreased in all patients with breast cancer receiving chemotherapy. The endocardial layer was the most vulnerable to chemotherapy-induced myocardial damage. Functional impairment was more profound in patients with CIC who received sequential anthracycline-trastuzumab chemotherapy. Thus, early evaluation of left ventricular function might be necessary for all patients with breast cancer to detect CIC.
- All Author(s)
- M. N. Kim
; S. R. Kim
; H. D. Kim
; D. H. Cho
; S. P. Jung
; K. H. Park
; S. M. Park
- Issued Date
- 2022
- Type
- Article
- Keyword
- Chemotherapy; Cardiotoxicity; Strain; Breast cancer; Endocardium
- Publisher
- European Society of Cardiology
- ISSN
- 2752-4191
- Citation Title
- European Heart Journal Open
- Citation Volume
- 2
- Citation Number
- 4
- Citation Start Page
- oeac008
- Citation End Page
- oeac008
- Language(ISO)
- eng
- DOI
- 10.1093/ehjopen/oeac008
- URI
- http://schca-ir.schmc.ac.kr/handle/2022.oak/2627
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