Cardiac function surveillance in patients during anti-cancer treatment: Initial experience with the CW-Doppler-based USCOM device and correlation to echocardiography and serum proBNP levels

Abstract

14648 Background: Cardiac function monitoring is essential during numerous anti-cancer treatments. For clinical routine, echocardiography is most commonly used for left ventricular systolic function surveillance. The primary goal of the present study was to determine the value of the CW-Doppler-based USCOM device (ultrasonic cardiac output monitoring) in monitoring the cardiac function of patients receiving anti-cancer therapy for various malignancies. Methods: 68 patients who received anti-cancer treatments [anthrazyclines (A) n=21, cetuximab (C) n=18, trastuzumab (T) n=10, bevacizumab (B) n=19] for mainly GI or breast cancers, were examined at 4 pre-defined times: T0 prior to first drug exposition, T1 subsequent to the first infusion, after 1 week (T2) and finally after 3 months of treatment (T3). Serum proBNP kinetics were compared to ejection fraction calculated by echocardiography (EFEcho; T0 and T3) and stroke volume measured by the USCOM device (SVUSCOM). Results: None of the patients developed clinically signs of overt heart failure. Parameters analyzed with the USCOM device (SVUSCOM) are in accordance to those measured by echocardiography (EFEcho) (→ table). Conclusion: The preliminary results of this study indicate a potential clinical value of the USCOM device in the cardiac function surveillance of patients during anti-cancer treatments. An outstanding advantage of the USCOM device is the less time needed (<1 min.) when compared to the well established but more time-consuming echocardiography. Further studies within more homogenous, pre-defined patient groups are initiated. T 0 T 1 T 2 T 3 Δ T0–3 (%) A SVUSCOM (ml) 75 84 83 64 85.3 A EFEcho (%) 68 - - 65 95.6 A proBNP (ng/ml) 208 286 234 310 149 C SVUSCOM (ml) 56 47 48.5 58 103.6 C EFEcho (%) 62.5 - - 72 115.2 C proBNP (ng/ml) 76.9 94.3 42.7 120 156 T SVUSCOM (ml) 70 55.5 80 76 108.6 T EFEcho (%) 63.5 - - 57 89.8 T proBNP (ng/ml) 126 116 132 113.4 89.9 B SVUSCOM (ml) 55 59 59 37.5 68.2 B EFEcho (%) 71 - - 67 94.4 B proBNP (ng/ml) 89.1 86.9 47.3 58.2 65.3 No significant financial relationships to disclose.