Comprehensive Cardiovascular Magnetic Resonance Tissue Characterization and Cardiotoxicity in Women With Breast Cancer
Authors' conclusion
In women with ERBB2-positive breast cancer receiving sequential anthracycline and trastuzumab therapy, CMR tissue biomarkers suggest inflammation and edema peaking early during therapy and were associated with ventricular remodeling and BNP elevation. However, the increases in CMR biomarkers were transient, were not associated with LVEF or myocardial strain, and were not useful in identifying traditional CTRCD risk.
Study context
- Population
- Women with ERBB2 (HER2)-positive breast cancer (stages I–III) scheduled for anthracycline and trastuzumab therapy with/without adjuvant radiotherapy and surgery, 3 University of Toronto-affiliated hospitals
- Participants
- 136 women
- Outcome
- Changes in CMR tissue biomarkers (relative myocardial enhancement, native T1, T2, ECV, late gadolinium enhancement (LGE)) and their association with CTRCD
- Follow-up
- Before anthracycline, after anthracycline, and at 3-month intervals during trastuzumab
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
CMR tissue biomarkers, baseline to peak (after anthracycline or 3 months after trastuzumab start)
- Relative myocardial enhancement, mean (SD): baseline 46.3% (16.8%) to peak 56.2% (18.6%)
- P <.001
- Native T1, mean (SD): 1012 (26) ms to 1035 (28) ms
- P <.001
- T2, mean (SD): 51.4 (2.2) ms to 52.6 (2.2) ms
- P <.001
- ECV, mean (SD): 25.2% (2.4%) to 26.8% (2.7%)
- P <.001
Observational data: associations, not effects.
Further findings
Cancer therapy-related cardiac dysfunction (CTRCD) incidence
- Developed CTRCD
- 37 (27%)
Associations of cardiovascular magnetic resonance (CMR) tissue biomarkers
- Increase in T1, T2 and/or ECV associated with increased ventricular volumes and BNP but not high-sensitivity cardiac troponin I (hs-cTnI)
- No CMR tissue biomarker associated with changes in LVEF or myocardial strain
Original publication
Comprehensive Cardiovascular Magnetic Resonance Tissue Characterization and Cardiotoxicity in Women With Breast Cancer. JAMA Cardiol. Published 1 June 2023. doi:10.
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