Abstract
<i>Background:</i> The oncological treatments have improved survival rates but with an increased risk of cardiovascular disease (CVD). <i>Purpose:</i> 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. <i>Patients and methods:</i> 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. <i>Results:</i> 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. <i>Conclusion:</i> 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.
Highlights
Novel anti-cancer drugs have improved survival rates but at the cost of a significantly increased risk of cardiovascular disease (CVD) [1, 2].Anthracyclines are known for relatively frequent cardiotoxic effects, which can be acute as myocarditis or chronic as ventricular dysfunction [3] or diffuse myocardial fibrosis [4]
Data are expressed as mean ± standard deviation (SD) and frequency (n - %) as well as median (IQR); a, either active smoking or previous history of smoking
Our study shows that treatment with potentially cardiotoxic drugs are associated with changes of myocardial T1 as a Cardiovascular Magnetic Resonance (CMR)-derived biomarker
Summary
Novel anti-cancer drugs have improved survival rates but at the cost of a significantly increased risk of CVD [1, 2].Anthracyclines are known for relatively frequent cardiotoxic effects, which can be acute as myocarditis or chronic as ventricular dysfunction [3] or diffuse myocardial fibrosis [4]. Novel anti-cancer drugs have improved survival rates but at the cost of a significantly increased risk of CVD [1, 2]. Chemotherapy-induced Cardiotoxicity in Breast Cancer Patients which are often subtle during initial phase of therapy [1] and do not include the early subclinical changes [3]. CMR has many advantages which may allow early identification of cardiotoxicity [8] It offers the opportunity of quantitative myocardial tissue assessment using novel methods such as T1 and T2 mapping [9]. 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
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