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Yamashita K, Tanaka H, Hatazawa K, Tanaka Y, Shono A, Suzuki M, Sumimoto K, Shibata N, Yokota S, Suto M, Dokuni K, Matsumoto K, Minami H, Hirata K. Association between clinical risk factors and left ventricular function in patients with breast cancer following chemotherapy. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
The sequential or concurrent use of two different types of agents such as anthracyclines and trastuzumab may increase myocardial injury and cancer therapeutics-related cardiac dysfunction (CTRCD), which is often the result of the combined detrimental effect of the two therapies for breast cancer patients. For risk stratification to detect the development of CTRCD, the current position paper from the European Society of Cardiology (ESC) lists several factors associated with risk of cardiotoxicity.
Purpose
Our purpose was to investigate the impact of baseline risk factors on left ventricular (LV) function in patients with preserved LV ejection fraction (LVEF) who have undergone chemotherapy for breast cancer.
Methods
We studied 86 breast cancer patients treated with anthracyclines, trastuzumab, or both. Mean age was 59 ± 13 years and LVEF was 67 ± 5%. In accordance with the current definition, CTRCD was defined as a decline in LVEF of >10% to an absolute value of <53% after chemotherapy. Based on the 2016 ESC position paper, clinical risk factors for CTRCD were defined as: (1) a cumulative total doxorubicin dose of ≥ 240mg/m², (2) age ≥ 65-year-old, (3) body mass index ≥ 30kg/m², (4) a previous history of radiation therapy to chest or mediastinum, (5) B-type natriuretic peptide ≥ 100pg/mL, (6) a previous history of cardiovascular disease, (7) atrial fibrillation, (8) hypertension, (9) diabetes mellitus, (10) current or ex-smoker.
Results
The relative decrease in LVEF after chemotherapy for patients with more than four risk factors was significantly greater than that for patients without (-9.3 ± 10.8% vs. -2.2 ± 10.2%; p = 0.02). However, this finding did not apply to patients with more than one, two or three risk factors. Patients with more than four risk factors also tended to show a higher prevalence of CTRCD than those without (14.3% vs. 2.8%, p = 0.12). Moreover, patients with more than four risk factors were more likely to have higher LV mass index (109.3 ± 29.0g/m² vs. 83.2 ± 21.0g/m², p < 0.001), lower global longitudinal strain (18.4 ± 2.8% vs. 20.0 ± 2.6%, p = 0.06) and higher E/e’ (10.4 (8.9-13.0) vs. 9.0 (7.4-10.9), p = 0.06) compared to those without.
Furthermore, receiver-operator characteristics curve analysis showed that an optimal cut off value of a cumulative total doxorubicin dose for developing LV dysfunction in patients with more than any of four risk factors was lower than that in those without (180 mg/m² vs. 280 mg/m²).
Conclusions
Association between clinical risk factors and LV dysfunction following chemotherapy became stronger with an increase in the number of risk factors in breast cancer patients, and was especially strong for patients treated with chemotherapy who had more than four risk factors. Our findings can thus be expected to have clinical implications for better management of patients with breast cancer referred for chemotherapy.
Abstract Figure.
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Affiliation(s)
| | | | | | | | - A Shono
- Kobe University, Kobe, Japan
| | | | | | | | | | - M Suto
- Kobe University, Kobe, Japan
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Yamashita K, Tanaka H, Hatazawa K, Tanaka Y, Sumimoto K, Shono A, Suzuki M, Yokota S, Suto M, Mukai J, Takada H, Matsumoto K, Minami H, Hirata K. Association between clinical risk factors and left ventricular function in patients with breast cancer following chemotherapy. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The sequential or concurrent use of two different types of agents such as anthracyclines and trastuzumab may increase myocardial injury and cancer therapeutics-related cardiac dysfunction (CTRCD), which is often the result of the combined detrimental effect of the two therapies for breast cancer patients. For risk stratification to detect the development of CTRCD, the current position paper from the European Society of Cardiology (ESC) lists several factors associated with risk of cardiotoxicity following treatment with chemotherapy. However, the association between clinical risk factors and left ventricular (LV) function in breast cancer patients is currently unclear.
Purpose
Our purpose was to investigate the impact of baseline risk factors on LV function in patients with preserved LV ejection fraction (LVEF) who have undergone anthracycline or trastuzumab chemotherapy for breast cancer.
Methods
We studied 86 breast cancer patients treated with anthracyclines, trastuzumab, or both. Mean age was 59±13 years and LVEF was 67±5%. In accordance with the current definition, CTRCD was defined as a decline in LVEF of >10% to an absolute value of <53% after chemotherapy. Based on the 2016 ESC position paper, clinical risk factors for CTRCD were defined as: (1) a cumulative total doxorubicin dose of ≥240 mg/m2, (2) age ≥65-year-old, (3) body mass index ≥30 kg/m2, (4) a previous history of radiation therapy to chest or mediastinum, (5) B-type natriuretic peptide ≥100pg/mL, (6) a previous history of cardiovascular disease, (7) atrial fibrillation, (8) hypertension, (9) diabetes mellitus, (10) current or ex-smoker.
Results
The relative decrease in LVEF after chemotherapy for patients with more than four risk factors was significantly greater than that for patients without (−9.3±10.8% vs. −2.2±10.2%; p=0.02). However, this finding did not apply to patients with more than one, two or three risk factors. Patients with more than four risk factors also tended to show a higher prevalence of CTRCD than those without (14.3% vs. 2.8%, p=0.12). Moreover, patients with more than four risk factors were more likely to have higher LV mass index (109.3±29.0 g/m2 vs. 83.2±21.0g /m2, p<0.001), lower global longitudinal strain (18.4±2.8% vs. 20.0±2.6%, p=0.06) and higher E/e' (10.4 (8.9–13.0) vs. 9.0 (7.4–10.9), p=0.06) compared to those without.
Conclusions
Association between clinical risk factors and LV dysfunction following chemotherapy became stronger with an increase in the number of risk factors in breast cancer patients, and was especially strong for patients treated with chemotherapy who had more than four risk factors. Our findings can thus be expected to have clinical implications for better management of patients with breast cancer referred for chemotherapy.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
| | | | | | | | | | - A Shono
- Kobe University, Kobe, Japan
| | | | | | - M Suto
- Kobe University, Kobe, Japan
| | - J Mukai
- Kobe University, Kobe, Japan
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Matsuzoe H, Matsumoto K, Tanaka H, Tahara N, Izawa Y, Toba T, Mori S, Suto M, Mukai J, Takada H, Soga F, Hatani Y, Hatazawa K, Shimoyama S, Hirata K. P6483Integrated assessment of aortic valve resistance using multi-detector computed tomography and echocardiography reflects aortic valvular burden and has prognostic value in patients with aortic stenosis. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- H Matsuzoe
- Kobe University, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe, Japan
| | - K Matsumoto
- Kobe University, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe, Japan
| | - H Tanaka
- Kobe University, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe, Japan
| | - N Tahara
- Kobe University, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe, Japan
| | - Y Izawa
- Kobe University, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe, Japan
| | - T Toba
- Kobe University, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe, Japan
| | - S Mori
- Kobe University, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe, Japan
| | - M Suto
- Kobe University, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe, Japan
| | - J Mukai
- Kobe University, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe, Japan
| | - H Takada
- Kobe University, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe, Japan
| | - F Soga
- Kobe University, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe, Japan
| | - Y Hatani
- Kobe University, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe, Japan
| | - K Hatazawa
- Kobe University, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe, Japan
| | - S Shimoyama
- Kobe University, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - K Hirata
- Kobe University, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe, Japan
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Suto M, Matsumoto K, Shibata N, Yokota S, Mukai J, Hisamatsu E, Takada H, Soga F, Dokuni K, Hatani Y, Hatazawa K, Matsuzoe H, Tanaka H, Hirata K. P1610Non-invasive assessment of preload reserve using the leg-positive pressure manoeuvre in patients with repaired tetralogy of Fallot. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M Suto
- Kobe University, Division of Cardiovascular Medicine, Kobe, Japan
| | - K Matsumoto
- Kobe University, Division of Cardiovascular Medicine, Kobe, Japan
| | - N Shibata
- Kobe University, Division of Cardiovascular Medicine, Kobe, Japan
| | - S Yokota
- Kobe University, Division of Cardiovascular Medicine, Kobe, Japan
| | - J Mukai
- Kobe University, Division of Cardiovascular Medicine, Kobe, Japan
| | - E Hisamatsu
- Kobe University, Division of Cardiovascular Medicine, Kobe, Japan
| | - H Takada
- Kobe University, Division of Cardiovascular Medicine, Kobe, Japan
| | - F Soga
- Kobe University, Division of Cardiovascular Medicine, Kobe, Japan
| | - K Dokuni
- Kobe University, Division of Cardiovascular Medicine, Kobe, Japan
| | - Y Hatani
- Kobe University, Division of Cardiovascular Medicine, Kobe, Japan
| | - K Hatazawa
- Kobe University, Division of Cardiovascular Medicine, Kobe, Japan
| | - H Matsuzoe
- Kobe University, Division of Cardiovascular Medicine, Kobe, Japan
| | - H Tanaka
- Kobe University, Division of Cardiovascular Medicine, Kobe, Japan
| | - K Hirata
- Kobe University, Division of Cardiovascular Medicine, Kobe, Japan
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Abstract
General-purpose colour cathode ray tube (CRT) monitors are used commonly for image display in personal computer-based picture archiving and communication system (PACS) and telemedicine systems. At present, however, we have not enough information about their performance or reliability for this task. Therefore, we studied the performance of five general-purpose colour CRTs and the changes in their performance in a year. Resolution was measured visually using original digital images. Maximum and minimum luminances were measured at the centre and periphery of the CRTs. Distortion was measured in the centre and periphery using original digital images. All the monitors met their specifications. The inhomogeneity of luminance exceeded 20% and varied across the CRTs. Darker monitors took more time to reach stable luminance levels. The corner brightness seemed to be a good estimator of both performance and distortion in colour monitors.
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Affiliation(s)
- H Kondoh
- Department of Medical Information Science, Tokushima University Medical Hospital, 2-50-1 Kuramoto-cho, 770-8503, Tokushima, Japan.
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Arimoto A, Saitoh S, Mochizuki T, Kikuchi Y, Hatazawa K. Dual beam laser diode scanning system for ultrahigh speed laser beam printers using a spot control method. Appl Opt 1987; 26:2554-2557. [PMID: 20489918 DOI: 10.1364/ao.26.002554] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
A dual beam laser diode scanning method for an ultrahigh speed laser printer is proposed and its feasibility is tested. Two separate laser beams are scanned simultaneously by one facet of a polygon mirror. By employing this method, power emitted from each laser and the rotation speed of the polygon mirror can be reduced to half, compared with those in single beam scanning systems. Spacing between two lines is compensated for by a sample-and-hold spot control method.
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