State-of-the-art CMR Mapping Techniques in the Detection of Subclinical Chemotherapy-induced Cardiotoxicity in Breast Cancer Patients

Background: The oncological treatments have improved survival rates but with an increased risk of cardiovascular disease (CVD). Purpose: To detect subclinical cardiotoxic changes using Cardiovascular Magnetic Resonance (CMR) and to define parameters for the prediction of late cardiac changes after 3 months follow-up. Patients and methods: We conducted a prospective study in 21 breast cancer patients who were scheduled to undergo treatment either with anthracyclines, trastuzumab, or docetaxel. CMR scans were performed before therapy onset as well as 3-6 days and 3 months thereafter. Native left ventricular (LV) T1 and T2 parameters were acquired in addition to standard parameters. Results: Compared to baseline, the mean left ventricular ejection fraction (LVEF) tended to mildly decrease during follow-up. A significant reduction in mean native T1 was found from 1246.6 ± 29.5 ms at baseline to 1231.4 ± 31.4 ms at 3-6 days, which was followed by significant increase after 3 months reaching 1265.8 ± 27.9 ms with p = 0.011 and 0.012, respectively. A significant increase in mean T2 was also found from 41.6 ± 3.4 ms at baseline to 43.8 ± 3.8 ms after 3 months with p = 0.045. From 21 patients, only 1 patient (4.8%) experienced cardiotoxicity. Conclusion: Treatment with potentially cardiotoxic drugs is associated with a change of CMR-derived native T1 which may enable an early identification of cardiotoxicity among breast cancer patients.