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Bergamini C, Niro L, Springhetti P, Ferri L, Trento L, Minnucci I, Maffeis C, Tafciu E, Rossi A, Fiorio E, Benfari G, Ribichini F. Role of Early Left Atrial Functional Decline in Predicting Cardiotoxicity in HER2 Positive Breast Cancer Patients Treated With Trastuzumab. Cardiovasc Toxicol 2024; 24:550-562. [PMID: 38696070 PMCID: PMC11102377 DOI: 10.1007/s12012-024-09861-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 04/13/2024] [Indexed: 05/19/2024]
Abstract
Trastuzumab is widely used in HER2 breast cancer. However, it may cause left ventricular (LV) dysfunction. A decrease in LV global longitudinal strain (GLS) has been previously demonstrated to be a good predictor of subsequent cancer therapy related dysfunction (CTRCD). Left atrial morphological remodeling during Trastuzumab therapy has also been shown. The aim of this study is exploring the relationship between early changes in left atrial function and the development of Trastuzumab-induced cardiotoxicity. Consecutive patients with diagnosis of HER2+non-metastatic breast cancer treated with Trastuzumab were prospectively enrolled. A clinical, conventional, and advanced echocardiographic assessment was performed at baseline and every three months, until a one-year follow-up was reached. One-hundred-sixteen patients completed the 12 months follow-up, 10 (9%) cases of CTRCD were observed, all after the sixth month. GLS and LVEF significantly decreased in the CTRCD group at 6 months of follow-up, with an earlier (3 months) significant worsening in left atrial morpho-functional parameters. Systolic blood pressure, early peak atrial longitudinal strain (PALS), peak atrial contraction (PACS) and left atrial volume (LAVI) changes resulted independent predictors of CTRCD at multivariable logistic regression analysis. Moreover, early changes in PALS and PACS resulted good predictors of CTRCD development (AUC 0.85; p = 0.008, p < 0.001 and 0.77; p = 0.008, respectively). This prospective study emphasizes that the decline in PALS and PACS among trastuzumab-treated patients could possibly increase the accuracy in identifying future CTRCD in non-metastatic HER2 breast cancer cases, adding predictive value to conventional echocardiographic assessment.
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Affiliation(s)
- Corinna Bergamini
- Department of Medicine, Section of Cardiology, University of Verona, Piazzale Aristide Stefani 1, 37100, Verona, VR, Italy.
| | - Lorenzo Niro
- Department of Medicine, Section of Cardiology, University of Verona, Piazzale Aristide Stefani 1, 37100, Verona, VR, Italy
| | - Paolo Springhetti
- Department of Medicine, Section of Cardiology, University of Verona, Piazzale Aristide Stefani 1, 37100, Verona, VR, Italy
| | - Luisa Ferri
- Department of Medicine, Section of Cardiology, University of Verona, Piazzale Aristide Stefani 1, 37100, Verona, VR, Italy
| | - Laura Trento
- Department of Medicine, Section of Cardiology, University of Verona, Piazzale Aristide Stefani 1, 37100, Verona, VR, Italy
| | - Ilaria Minnucci
- Department of Medicine, Section of Cardiology, University of Verona, Piazzale Aristide Stefani 1, 37100, Verona, VR, Italy
| | - Caterina Maffeis
- Department of Medicine, Section of Cardiology, University of Verona, Piazzale Aristide Stefani 1, 37100, Verona, VR, Italy
| | - Elvin Tafciu
- Department of Medicine, Section of Cardiology, University of Verona, Piazzale Aristide Stefani 1, 37100, Verona, VR, Italy
| | - Andrea Rossi
- Department of Medicine, Section of Cardiology, University of Verona, Piazzale Aristide Stefani 1, 37100, Verona, VR, Italy
| | - Elena Fiorio
- Department of Medicine, Section of Oncology, University of Verona, 37100, Verona, VR, Italy
| | - Giovanni Benfari
- Department of Medicine, Section of Cardiology, University of Verona, Piazzale Aristide Stefani 1, 37100, Verona, VR, Italy
| | - Flavio Ribichini
- Department of Medicine, Section of Cardiology, University of Verona, Piazzale Aristide Stefani 1, 37100, Verona, VR, Italy
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Egashira K, Sueta D, Kidoh M, Tomiguchi M, Oda S, Usuku H, Hidaka K, Goto-Yamaguchi L, Sueta A, Komorita T, Oike F, Fujisue K, Yamamoto E, Hanatani S, Takashio S, Araki S, Matsushita K, Yamamoto Y, Hirai T, Tsujita K. Cardiac computed tomography-derived myocardial tissue characterization after anthracycline treatment. ESC Heart Fail 2022; 9:1792-1800. [PMID: 35289088 PMCID: PMC9065838 DOI: 10.1002/ehf2.13867] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 01/24/2022] [Accepted: 02/17/2022] [Indexed: 12/28/2022] Open
Abstract
AIMS Understanding cardiac function after anthracycline administration is very important from the perspective of preventing the onset of heart failure. Although cardiac magnetic resonance and echocardiography are recognized as the 'gold standard' for detecting cardiotoxicity, they have many shortcomings. We aimed to investigate whether cardiac computed tomography (CCT) could replace these techniques, assessing serial changes in cardiac tissue characteristics as determined by CCT after anthracycline administration. METHODS AND RESULTS We prospectively investigated 15 consecutive breast cancer patients who were scheduled to receive anthracycline therapy. We performed echocardiography and CCT before and 3, 6, and 12 months after anthracycline treatment. The mean cumulative administered anthracycline dose was 269.9 ± 14.6 mg/m2 (doxorubicin-converted dose). Of the 15 enrolled patients who received anthracycline treatment for breast cancer, none met the definition of cardiotoxicity. The CCT-derived extracellular volume fraction tended to continue to increase after anthracycline treatment and had relatively similar dynamics to the left ventricular ejection fraction and global longitudinal strain as determined by echocardiography. CONCLUSIONS Our findings indicated that CCT could provide adequate information about the characteristics of myocardial tissue after anthracycline administration. CCT may improve the understanding of cardiotoxicity by compensating for the weaknesses of echocardiography. This technique could be useful for understanding cardiac tissue characterization as a 'one-stop shop' evaluation, providing new insight into cardiooncology.
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Affiliation(s)
- Koichi Egashira
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Daisuke Sueta
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Masafumi Kidoh
- Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Mai Tomiguchi
- Breast and Endocrine Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Seitaro Oda
- Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Hiroki Usuku
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.,Department of Laboratory Medicine, Kumamoto University Hospital, Kumamoto, Japan
| | - Kaori Hidaka
- Breast and Endocrine Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Lisa Goto-Yamaguchi
- Breast and Endocrine Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Aiko Sueta
- Breast and Endocrine Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Takashi Komorita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Fumi Oike
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Koichiro Fujisue
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Eiichiro Yamamoto
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Shinsuke Hanatani
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Seiji Takashio
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Satoshi Araki
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Kenichi Matsushita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.,Division of Advanced Cardiovascular Therapeutics, Kumamoto University Hospital, Kumamoto, Japan
| | - Yutaka Yamamoto
- Breast and Endocrine Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Toshinori Hirai
- Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
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Chen D, Yan Z, Fan L, Rui Y. Evaluation of Cardiac Function before and after PAD Regimen in Patients with Multiple Myeloma by Three-Dimensional Speckle Tracking Imaging. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:1849969. [PMID: 35126904 PMCID: PMC8813262 DOI: 10.1155/2022/1849969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/25/2021] [Accepted: 01/12/2022] [Indexed: 11/17/2022]
Abstract
In this manuscript, we have evaluated numerous changes of cardiac function in patients with multiple myeloma before and after PAD chemotherapy with 3D speck tracking imaging (3D-STI). For this purpose, 39 patients with multiple myeloma, from July 2019 to December 2020, who received the PAD regimen (bortezomib + doxorubicin liposome + dexamethasone, a course of 12 days) were selected as subjects. A comparison of two-dimensional conventional echocardiographic parameters before and after chemotherapy and 3D-STI related parameters was carried out. After 6 cycles of chemotherapy, the levels of TAPSE, RVFAC, and LVEF were significantly lower than those before chemotherapy (P < 0.05). There was no significant difference in the results of left and right ventricle two-dimensional conventional echocardiography before chemotherapy and 2 or 4 cycles after chemotherapy (P > 0.05). There were significant differences in the levels of RVGCS, RVGLS, RVGRS, LVGLS, and LVGRS before and after chemotherapy (P < 0.05). Specifically, RVGCS: after 6 cycles of chemotherapy < after 4 cycles of chemotherapy < before chemotherapy; RVGLS: after 6 cycles of chemotherapy < after 4 cycles of chemotherapy < after 2 cycles of chemotherapy < before chemotherapy; RVGRS: after 6 cycles of chemotherapy < after 4 cycles of chemotherapy < before chemotherapy; LVGLS: after 6 cycles of chemotherapy < after 4 cycles of chemotherapy < before chemotherapy; and LVGRS: after 6 cycles of chemotherapy < before chemotherapy. The results of Pearson correlation analysis showed that the dose of doxorubicin was negatively correlated with RVGCS, RVGLS, RVGRS, and LVGLS, but not with TAPSE, RVFAC, LVEF, and LVGRS. 3D-STI is helpful for early detection of the changes of left and right ventricular myocardial function after PAD chemotherapy in patients with multiple myeloma. And the early screening value of the RVGLS parameter is higher.
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Affiliation(s)
- Dongliang Chen
- The Affiliated Changzhou NO.2 People's Hospital of Nanjing Medical University, Department of Echocardiography, Changzhou, Jiangsu 213003, China
| | - Zining Yan
- The Affiliated Changzhou NO.2 People's Hospital of Nanjing Medical University, Department of Echocardiography, Changzhou, Jiangsu 213003, China
| | - Li Fan
- The Affiliated Changzhou NO.2 People's Hospital of Nanjing Medical University, Department of Echocardiography, Changzhou, Jiangsu 213003, China
| | - Yifei Rui
- The Affiliated Changzhou NO.2 People's Hospital of Nanjing Medical University, Department of Echocardiography, Changzhou, Jiangsu 213003, China
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Egashira K, Sueta D, Tomiguchi M, Kidoh M, Oda S, Usuku H, Hidaka K, Goto-Yamaguchi L, Sueta A, Komorita T, Takae M, Oike F, Fujisue K, Yamamoto E, Hanatani S, Takashio S, Arima Y, Araki S, Kaikita K, Matsushita K, Yamamoto Y, Hirai T, Tsujita K. Cardiac computed tomography-derived extracellular volume fraction in late anthracycline-induced cardiotoxicity. IJC HEART & VASCULATURE 2021; 34:100797. [PMID: 34041357 PMCID: PMC8144341 DOI: 10.1016/j.ijcha.2021.100797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 05/08/2021] [Indexed: 11/20/2022]
Abstract
Cardiotoxicity in the late phase after anthracycline drugs administration remains to be defined. Of the 44 patients who received anthracycline treatment, 7 were found to have cancer therapeutics–related cardiac dysfunction (CTRCD). The global longitudinal strain determined by echocardiography and myocardial extracellular volume fraction (ECV) determined by cardiac computed tomography (CCT) of the CTRCD(+) group were significantly higher than those of the control group and CTRCD(-) group, whereas there were no significant differences between the control and CTRCD(-) groups. Our findings indicated that CCT may be a tool comparable to echocardiography, indicating the effective evaluation of CTRCD by CCT.
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Affiliation(s)
- Koichi Egashira
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto, Japan.,Center for Metabolic Regulation of Healthy Aging, Graduate School of Medical Sciences, Kumamoto, Japan
| | - Daisuke Sueta
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto, Japan.,Center for Metabolic Regulation of Healthy Aging, Graduate School of Medical Sciences, Kumamoto, Japan
| | - Mai Tomiguchi
- Breast and Endocrine Surgery, Graduate School of Medical Sciences, Kumamoto, Japan
| | - Masafumi Kidoh
- Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto, Japan
| | - Seitaro Oda
- Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto, Japan
| | - Hiroki Usuku
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto, Japan.,Center for Metabolic Regulation of Healthy Aging, Graduate School of Medical Sciences, Kumamoto, Japan.,Department of Laboratory Medicine, Kumamoto University Hospital, Kumamoto, Japan
| | - Kaori Hidaka
- Breast and Endocrine Surgery, Graduate School of Medical Sciences, Kumamoto, Japan
| | - Lisa Goto-Yamaguchi
- Breast and Endocrine Surgery, Graduate School of Medical Sciences, Kumamoto, Japan
| | - Aiko Sueta
- Breast and Endocrine Surgery, Graduate School of Medical Sciences, Kumamoto, Japan
| | - Takashi Komorita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto, Japan.,Center for Metabolic Regulation of Healthy Aging, Graduate School of Medical Sciences, Kumamoto, Japan
| | - Masafumi Takae
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto, Japan.,Center for Metabolic Regulation of Healthy Aging, Graduate School of Medical Sciences, Kumamoto, Japan
| | - Fumi Oike
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto, Japan.,Center for Metabolic Regulation of Healthy Aging, Graduate School of Medical Sciences, Kumamoto, Japan
| | - Koichiro Fujisue
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto, Japan.,Center for Metabolic Regulation of Healthy Aging, Graduate School of Medical Sciences, Kumamoto, Japan
| | - Eiichiro Yamamoto
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto, Japan.,Center for Metabolic Regulation of Healthy Aging, Graduate School of Medical Sciences, Kumamoto, Japan
| | - Shinsuke Hanatani
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto, Japan.,Center for Metabolic Regulation of Healthy Aging, Graduate School of Medical Sciences, Kumamoto, Japan
| | - Seiji Takashio
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto, Japan.,Center for Metabolic Regulation of Healthy Aging, Graduate School of Medical Sciences, Kumamoto, Japan
| | - Yuichiro Arima
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto, Japan.,Center for Metabolic Regulation of Healthy Aging, Graduate School of Medical Sciences, Kumamoto, Japan
| | - Satoshi Araki
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto, Japan.,Center for Metabolic Regulation of Healthy Aging, Graduate School of Medical Sciences, Kumamoto, Japan
| | - Koichi Kaikita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto, Japan.,Center for Metabolic Regulation of Healthy Aging, Graduate School of Medical Sciences, Kumamoto, Japan
| | - Kenichi Matsushita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto, Japan.,Center for Metabolic Regulation of Healthy Aging, Graduate School of Medical Sciences, Kumamoto, Japan.,Division of Advanced Cardiovascular Therapeutics, Kumamoto University Hospital, Kumamoto, Japan
| | - Yutaka Yamamoto
- Breast and Endocrine Surgery, Graduate School of Medical Sciences, Kumamoto, Japan
| | - Toshinori Hirai
- Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto, Japan
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto, Japan.,Center for Metabolic Regulation of Healthy Aging, Graduate School of Medical Sciences, Kumamoto, Japan
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5
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Sueta D, Kidoh M, Oda S, Egashira K, Yamamoto E, Kaikita K, Matsushita K, Yamamoto Y, Hirai T, Tsujita K. Usefulness of Cardiac Computed Tomography in the Diagnosis of Anti-Cancer Therapy-Related Cardiac Dysfunction - Consistency With Magnetic Resonance Imaging. Circ J 2021; 85:393-396. [PMID: 33597324 DOI: 10.1253/circj.cj-20-1288] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Cardiac magnetic resonance (CMR) imaging is the golden standard used for the diagnosis of cancer therapy-related cardiac dysfunction (CTRCD). The consistency of cardiac computed tomography (CCT) in CTRCD cases using CMR imaging is investigated in this study.Methods and Results:In 7 clinically confirmed CTRCD patients, focal late enhancement was confirmed on both CCT and CMR for 4 patients. Myocardial extracellular volume (ECV) values measured by CCT and CMR were elevated in all patients, suggesting the presence of diffuse myocardial damage. CONCLUSIONS The study findings indicated that CCT could provide adequate information about late myocardial enhancement and ECV quantification, indicating the effective evaluation of CTRCD by CCT.
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Affiliation(s)
- Daisuke Sueta
- Department of Cardiovascular Medicine, Kumamoto University School of Medicine
| | - Masafumi Kidoh
- Department of Diagnostic Radiology, Kumamoto University School of Medicine
| | - Seitaro Oda
- Department of Diagnostic Radiology, Kumamoto University School of Medicine
| | - Koichi Egashira
- Department of Cardiovascular Medicine, Kumamoto University School of Medicine
| | - Eiichiro Yamamoto
- Department of Cardiovascular Medicine, Kumamoto University School of Medicine
| | - Koichi Kaikita
- Department of Cardiovascular Medicine, Kumamoto University School of Medicine
| | - Kenichi Matsushita
- Department of Cardiovascular Medicine, Kumamoto University School of Medicine.,Division of Advanced Cardiovascular Therapeutics, Kumamoto University Hospital
| | - Yutaka Yamamoto
- Department of Breast and Endocrine Surgery, Kumamoto University School of Medicine
| | - Toshinori Hirai
- Department of Diagnostic Radiology, Kumamoto University School of Medicine
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Kumamoto University School of Medicine
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Sueta D, Usuku H, Kinoshita Y, Tsujita K. Left atrial function assessed by speckle tracking echocardiography in anthracycline-induced cardiotoxicity: a case report. EUROPEAN HEART JOURNAL-CASE REPORTS 2020; 4:1-5. [PMID: 33442607 PMCID: PMC7793052 DOI: 10.1093/ehjcr/ytaa355] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 06/16/2020] [Accepted: 09/08/2020] [Indexed: 01/09/2023]
Abstract
Background The onset prevention and early diagnosis in cardiotoxicity due to cancer chemotherapy are important, and it is important to detect cardiac dysfunction at an early stage and start treatment to enhance the therapeutic effect. Case summary A 31-year-old female with breast cancer received chemotherapy with epirubicin (400 mg/m2) and cyclophosphamide followed by docetaxel. Two months after the initiation of her chemotherapy, the left ventricular (LV) ejection fraction (LVEF) determined by echocardiography fell to 41.2%, and she was diagnosed with cancer therapy-related cardiac dysfunction (CTRCD). Three months after the initiation of cancer treatment, the peak velocity of late diastolic transmitral Doppler flow (A wave) became undetectable. Peak longitudinal strain (LS) and peak LS rate, which reflect left atrium (LA) reservoir function, gradually declined like the LVEF and LV-global LS (GLS). Seven months after the initiation of cancer treatment, she was diagnosed with acute decompensated heart failure. The changes in peak LS and peak LS at the onset were greater than those in LVEF and LV-GLS. Discussion This is a case report suggesting that LA reservoir function might be a more sensitive indicator than LVEF or LV-GLS in detecting CTRCD and that LA booster function might be the earliest. Left atrium reservoir function might be a more sensitive than conventional LV pump function and optimal indicator in CTRCD.
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Affiliation(s)
- Daisuke Sueta
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Hiroki Usuku
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan.,Department of Molecular Laboratory, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Yui Kinoshita
- Department of Molecular Laboratory, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan
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