Evaluation of left ventricular function in breast cancer with targeted therapy by gated equilibration ventriculography

Abstract

Objective To observe the evaluation function of gated equilibration ventriculography for the changes of left ventricular function in breast cancer with targeted therapy. Methods From February 2016 to December 2017, a total of 60 female breast cancer patients (age: 28-65 (48.7±9.4) years) were included prospectively. Patients were divided into 2 groups: lapatinib combined with taxeme-based chemotherapy group (group A; n=25, age: 29-65 (47.8±11.3) years) and lapatinib monotherapy group (group B; n=35, age: 31-62 (51.1±8.5) years). All patients underwent gated equilibration ventriculography before treatment and 6/12 months after treatment. The parameters of left ventricular function including left ventricle ejection fraction (LVEF), peak ejection rate (PER), peak filling rate (PFR), 1/3 ejection fraction (EF), 1/3 filling fraction (FF), time to peak ejection rate (TPER) and time of peak filling rate (TPFR) were observed. Repeated measurement analysis of variance, independent-samples t test and Wilcoxon rank sum test were performed. Results In group A, the PER at 12 months after treatment ((3.11±0.48) end-diastolic volume (EDV)/s) was lower than that before treatment ((3.60±0.62) EDV/s; F=3.447, t=0.60, P 0.05); the PFR at 6 months ((3.07±0.71) EDV/s) and 12 months after treatment ((2.84±0.54) EDV/s) declined significantly compared with that before treatment ((3.57±0.81) EDV/s; F=5.345, t=0.82 and 0.75, both P<0.05). In group B, the PFR at 12 months after treatment ((2.86±0.55) EDV/s) declined significantly compared with that before treatment ((3.23±0.87) EDV/s; F=3.214, t=0.84, P<0.05). The decrease of PFR at 6 months and 12 months after treatment in group A was greater than that in group B (-0.37(-0.78, 0.15) vs -0.13(-0.44, 0.17) EDV/s; z=-1.569, P<0.05). Conclusions The gated equilibration ventriculography can effectively monitor the left ventricular function of breast cancer patients after targeted therapy. PER and PFR may be more sensitive than other parameters to assess heart function changes. The lapatinib combined with taxeme-based chemotherapy can affect diastolic function more and earlier than lapatinib monotherapy. Key words: Breast neoplasms; Molecular targeted therapy; Cardiotoxicity; Ventricular function, left; Gated blood-pool imaging