Decoding Anthracycline- and Trastuzumab-Related Cardiac Dysfunction Prediction: Heart Failure Association-International Cardio-Oncology Society (HFA-ICOS) Scores Versus Strain Imaging
Authors' conclusion
Contemporary anthracycline and trastuzumab-based regimens resulted in similarly low incidences of CTRCD. In this context, LV-GLS evolution was the best predictor of CTRCD.
Study context
- Population
- Chemotherapy-naïve women with breast cancer and cardiovascular risk factors, scheduled to receive anthracycline or trastuzumabchemotherapy-naïve women with breast cancer
- Participants
- 443 women
- Exposure
- Baseline HFA-ICOS risk score added to relative decline of left ventricular global longitudinal strain (LV-GLS) > 15% for predicting cancer therapy-related cardiac dysfunction (CTRCD)
- Anthracyclinen = 333
- Trastuzumabn = 110
- Outcome
- HFA-ICOS risk stratification
- Follow-up
- Baseline
Methodological detailsprospectively enrolled
- Prospectively enrolled
Main finding
As reported in the abstract
Low risk
258 patients
58.2%
Moderate risk
180
40.6%
High risk
5
1.2%
Observational data: associations, not effects.
Further findings
Asymptomatic CTRCD
Prediction of CTRCD by relative decline of LV-GLS > 15%
AUC anthracycline 0.93, 95% CI 0.89-0.96 · trastuzumab 0.97, 95% CI 0.88-0.99
Sensitivity
Specificity
Prediction of CTRCD by relative decline of LV-GLS > 15%
- Addition of baseline HFA-ICOS risk score did not improve performance
Original publication
Decoding Anthracycline- and Trastuzumab-Related Cardiac Dysfunction Prediction: HFA-ICOS Scores Versus Strain Imaging. ESC Heart Fail. Published 14 August 2025. doi:10.
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