Key result
Lower baseline constructive work and rising wasted work are linked to anthracycline-induced cardiac dysfunction.
Why the study?
Serial TTE assessment of LVEF and GLS are standard for CTRCD screening, but non-invasive LV pressure-strain loop has emerged as a novel method to quantify myocardial work.
Do serial non-invasive myocardial work measurements identify breast cancer patients at risk for cancer therapeutics-related cardiac dysfunction during anthracycline therapy?
Observational (n=50)
No
Do serial non-invasive myocardial work measurements identify breast cancer patients at risk for cancer therapeutics-related cardiac dysfunction during anthracycline therapy?
Non-invasive myocardial work indices, specifically low baseline constructive work and increased wasted work at follow-up, may help identify breast cancer patients at risk for cardiotoxicity.
Answers are grounded in this paper and cite their sources.
MW indices may track early CTRCD trajectories; hypothesis-generating and requires prospective validation before clinical adoption.
Serial transthoracic echocardiographic (TTE) assessment of LVEF and GLS are the gold standard in screening Cancer Therapeutics-Related Cardiac Dysfunction (CTRCD). Non-invasive left-ventricle (LV) pressure–strain loop (PSL) emerged as a novel method to quantify Myocardial Work (MW). This study aims to describe the temporal changes and longitudinal trajectories of MW indices during cardiotoxic treatment. We included 50 breast cancer patients with normal LV function referred for anthracycline therapy w/wo Trastuzumab. Medical therapy, clinical and echocardiographic data were recorded before and 3, 6, and 12 months after initiation of the chemotherapy. MW indices were calculated through PSL analysis. According to ESC guidelines, mild and moderated CTRCD was detected in 10 and 9 patients, respectively (20% CTRCDmild, 18% CTRCDmod), while 31 patients remained free of CTRCD (62% CTRCDneg). Prior to chemotherapy MWI, MWE and CW were significantly lower in CTRCDmod than in CTRCDneg and CTRCDmild. Overt cardiac dysfunction in CTRCDmod at 6 months was accompanied by significant worse values in MWI, MWE and WW compared to CTRCDneg and CTRCDmild. MW features such as low baseline CW, especially when associated with a rise in WW at follow-up, may identify patients at risk for CTRCD. Additional studies are needed to explore the role of MW in CRTCD.
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Moyá et al. (2023) conducted an observational in Breast cancer (n=50). Anthracycline therapy with or without Trastuzumab was evaluated on Cancer Therapeutics-Related Cardiac Dysfunction (CTRCD). Anthracycline therapy led to mild (20%) or moderate (18%) cardiac dysfunction, which was associated with lower baseline constructive work and a rise in wasted work at follow-up.
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