Chemotherapy with or without radiotherapy in female breast cancer patients was associated with global longitudinal strain alteration (≥15% relative decline) in 42% of patients over 1 year.
Observational (n=108)
No
Does chemotherapy cause global longitudinal strain (GLS) alteration in female breast cancer patients?
Routine GLS monitoring in breast cancer patients undergoing chemotherapy reveals a high incidence (42%) of subclinical myocardial dysfunction within one year.
Abstract Background The alteration of global longitudinal strain (GLS) in patients undergoing chemotherapy is an important area of research in cardiology and oncology since it’s a strong predictor of impaired LVEF, that’s why monitoring GLS before, during, and after chemotherapy can help detect early signs of myocardial dysfunction and guide clinical management. Objective The aim of this study was to follow the evolution of GLS in breast cancer patients treated with chemotherapy, with or without radiotherapy. Methods A prospective, observational, monocentric study was conducted involving 108 breast cancer patients referred to the cardio-oncology unit of our hospital from September 2022 to October 2023. Patients underwent baseline cardiovascular assessments, including echocardiography and GLS measurement. Patients were asked to follow up after 3 and 6 months and 1 year from the start of the chemotherapy. GLS alteration was defined as a new relative decline in GLS by 15% from baseline. Results Out of 108 patients, 88 completed follow-up. GLS alteration was observed in 42% of patients during the study period. The mean age of our population was 50 ±11 years, ranging from 27 to 79 years. 83% were diagnosed with invasive ductal carcinoma and 17% with invasive lobular carcinoma. 26.1% of patients had metastatic breast cancer. Obesity was the most common cardiovascular risk factor (28%, n=26) with a mean BMI of 27.68 kg/m² ( 19-40 ± 4.01) followed by hypertension ( 19%, n=17), dyslipidemia (14%, n=12) and diabetes (13%, n=11). 9% of the patients had a history of anthracycline-based chemotherapy, 2% had HER2-neu inhibitor-based chemotherapy, 9% had other types of chemotherapy and only 5% had previously received thoracic radiotherapy. Anthracyclines, followed by alkylating agents, taxane-type antimicrotubules, and antiHER2neu monoclonal antibodies were the most frequently used types of chemotherapy, with percentages of 85% (n=75), 84% (74), 82%(n=72), and 43% (n=38), respectively 26 patients received thoracic radiotherapy (30%), with an average dose of 48.84 ± 6.94 Gy. Among these patients, 46% received radiotherapy to the right breast and 54% to the left breast The average LVEF at baseline was 63% ± 5 %, with a GLS of - 20.03% ± 2.20 % . There were no segmental wall motion abnormalities, the average left ventricular mass was 79± 16.71 mg/m², and only 8% had concentric left ventricular hypertrophy.None of the patients had significant valvular disease. During follow-up GLS alteration was observed in 37 (42%) patients. The mean delta-strain was 12.8% ± 8.78 % in the study population, 21,15% ± 6,41% in the group with GLS impairment and 6,75% ± 3,98% in the group without GLS impairment. 12 patients (32%) developed GLS impairment at 3 months, 14 (38%) at 6 months and 11 (30%) at 12 months follow-up. Conclusion Routine GLS monitoring holds promise in minimizing the cardiac burden associated with cancer therapy.Evolution of LVEF, GLS and Delta Strain Evolution with and without GLS alteratio
Moussi et al. (Sat,) conducted a observational in Breast cancer (n=108). Chemotherapy with or without radiotherapy was evaluated on Global longitudinal strain (GLS) alteration (relative decline ≥15% from baseline). Chemotherapy with or without radiotherapy in female breast cancer patients was associated with global longitudinal strain alteration (≥15% relative decline) in 42% of patients over 1 year.