What question did this study set out to answer?

To assess the long-term effects of standard chemotherapy regimens on myocardial function in asymptomatic breast cancer survivors using two-dimensional speckle tracking echocardiography.

April 27, 2010Heart

Subclinical anthracycline- and trastuzumab-induced cardiotoxicity in the long-term follow-up of asymptomatic breast cancer survivors: a speckle tracking echocardiographic study

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Why the study?

Does prior anthracycline and trastuzumab chemotherapy cause subclinical myocardial dysfunction in asymptomatic breast cancer survivors compared to healthy controls?

Population

120 women, including 70 asymptomatic breast cancer survivors who had received anthracycline treatment with…

Comparison

Prior standard chemotherapy including… vs Female controls without prior chemotherapy

Design

Cohort

Follow-up

up to 6 years

Authors

EHE. HøUniversity of Copenhagen ABAngela L. BrownUniversity Ucinf RMRóisín B. MorganMaine Medical Center

Discussion

Member takes

Implication

Speckle tracking may detect subclinical dysfunction in asymptomatic survivors; leaves open whether screening improves outcomes.

Key Points

To assess the long-term effects of standard chemotherapy regimens on myocardial function in asymptomatic breast cancer survivors using two-dimensional speckle tracking echocardiography.
Evaluated 70 women (aged 54±8 years) treated up to 6 years prior with anthracyclines, either with (n=19) or without (n=51) adjuvant trastuzumab, alongside 50 female controls.
Measured left ventricular systolic parameters (EF%, peak systolic excursion Sm) and diastolic parameters (E/A ratio, mitral annular E' velocities) using 2D and tissue Doppler echocardiography.
Quantified 2D global and regional longitudinal and radial strain using speckle tracking echocardiographic software.
Despite preserved ejection fraction (62±4% vs 60±3%, p=0.051), chemotherapy recipients exhibited reduced E/A ratios (0.9±0.3 vs 1.1±0.3, p=0.003), global E' (10.2±2 vs 11.2±2.3, p=0.036), global Sm (9.0±1.3 vs 9.6±1.3, p=0.029), and global longitudinal 2D strain (-18.1±2.2 vs -19.6±1.8, p=0.0001) compared to controls.
Global longitudinal strain fell below the lower limit of controls in 18 chemotherapy recipients (26%), with cigarette smoking identified as a significant negative predictor of strain only within the chemotherapy group.
Radial strain showed no significant difference between groups, and adjuvant trastuzumab caused no additional significant decline in EF%, global Sm, or longitudinal strain compared to anthracyclines alone.

Structured PICO

Does prior anthracycline and trastuzumab chemotherapy cause subclinical myocardial dysfunction in asymptomatic breast cancer survivors compared to healthy controls?

Population

120 women, including 70 asymptomatic breast cancer survivors (mean age 54+/-8 years) who had received anthracycline treatment with (n=19) or without (n=51) adjuvant trastuzumab up to 6 years previously, and 50 female controls.

Intervention

Prior standard chemotherapy including anthracycline treatment with or without adjuvant trastuzumab

Comparator

Female controls without prior chemotherapy

Outcome

Left ventricular systolic function (ejection fraction, peak systolic myocardial excursion), diastolic function (peak mitral E and A velocities, six-point average of mitral annular E' velocities), and 2D global and regional longitudinal and radial strainsurrogate

Asymptomatic breast cancer survivors demonstrate subclinical systolic and diastolic myocardial abnormalities up to 6 years after anthracycline-based chemotherapy, which can be detected using speckle tracking echocardiography.

Cite This Study

Hø et al. (2010) studied this question.

synapsesocial.com/papers/6a7d482a9947580f698b26ce https://doi.org/10.1136/hrt.2009.173997

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Subclinical anthracycline- and trastuzumab-induced cardiotoxicity in the long-term follow-up of asymptomatic breast cancer survivors: a speckle tracking echocardiographic study

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Subclinical anthracycline- and trastuzumab-induced cardiotoxicity in the long-term follow-up of asymptomatic breast cancer survivors: a speckle tracking echocardiographic study

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider