Serial Measurements of Left Ventricular Systolic and Diastolic Function by Cardiac Magnetic Resonance Imaging in Patients with Early Stage Breast Cancer on Trastuzumab.

Our aim was to evaluate the temporal changes in left ventricular (LV) diastolic filling in relation to other LV parameters using cardiac MRI (CMR) in patients with HER2 positive breast cancer receiving trastuzumab therapy. Fourty-one women with early stage HER2+ breast cancer underwent serial CMR (baseline, 6, 12, and 18 months) after initiation of trastuzumab therapy. A single, blinded observer measured LV parameters on de-identified CMRs in random order. Linear mixed models were used to investigate temporal changes. Compared to baseline, there were significant decreases in systolic function as measured by both left ventricular ejection fraction (LVEF) (p <0.001 at 6 and 12 months) and peak ejection rate corrected for end-diastolic volume (PER/LVEDV) (p = 0.008 at 6 months, p = 0.01 at 12 months). However, these differences were no longer significant at 18 months. In contrast, significant reductions in diastolic function as measured by LV peak filling rate corrected for end-diastolic volume (PFR/LVEDV) were observed at 6 months (p = 0.012), 12 months (p = 0.031), and up to 18 months (p = 0.034). There were no significant temporal changes in the time to peak filling rate corrected for cardiac cycle (TPF/RR). The reduction in PFR/LVEDV at 18 months was no longer significant when corrected for heart rate. In conclusion, there were significant subclinical deleterious effects on both LV systolic and diastolic function among patients receiving trastuzumab. While there was recovery in LV systolic function after therapy cessation at 18 months, reduction in PFR/LVEDV appeared to persist. Thus, diastolic dysfunction may serve as a marker of trastuzumab-induced cardiotoxicity that needs to be confirmed in a larger study.

Song L ，Brezden-Masley C ，Ramanan V ，Ghugre N ，Barfett JJ ，Chan KKW ，Haq R ，Petrella T ，Dhir V ，Jimenez-Juan L ，Chacko BR ，Kotha V ，Connelly KA ，Yan AT ... -  《-》

Early diastolic strain rate measurements by cardiac MRI in breast cancer patients treated with trastuzumab: a longitudinal study.

Gong IY ，Ong G ，Brezden-Masley C ，Dhir V ，Deva DP ，Chan KKW ，Graham JJ ，Chow CM ，Thavendiranathan P ，Dai D ，Ng MY ，Barfett JJ ，Connelly KA ，Yan AT ... -  《-》

Longitudinal assessment of right ventricular structure and function by cardiovascular magnetic resonance in breast cancer patients treated with trastuzumab: a prospective observational study.

Barthur A ，Brezden-Masley C ，Connelly KA ，Dhir V ，Chan KK ，Haq R ，Kirpalani A ，Barfett JJ ，Jimenez-Juan L ，Karur GR ，Deva DP ，Yan AT ... -  《-》

Assessment of left ventricular function by CMR versus MUGA scans in breast cancer patients receiving trastuzumab: a prospective observational study.

Dhir V ，Yan AT ，Nisenbaum R ，Sloninko J ，Connelly KA ，Barfett J ，Haq R ，Kirpalani A ，Chan KKW ，Petrella TM ，Brezden-Masley C ... -  《-》

Impacts of non-recovery of trastuzumab-induced cardiomyopathy on clinical outcomes in patients with breast cancer.

Yoon HJ ，Kim KH ，Kim HY ，Park H ，Cho JY ，Hong YJ ，Park HW ，Kim JH ，Ahn Y ，Jeong MH ，Cho JG ，Park JC ... -  《-》