Impaired Cardiac and Skeletal Muscle Energetics Following Anthracycline Therapy for Breast Cancer
Authors' conclusion
Contemporary doses of epirubicin for breast cancer treatment result in a significant reduction of cardiac and skeletal muscle high-energy 31P-metabolism alongside structural skeletal muscle changes.
Study context
- Population
- Chemotherapy-naive women with breast cancer receiving epirubicin (median age 53 years)
- Participants
- 25 vs 25
- Comparison
- Breast cancer patients receiving epirubicin vs sex- and age-matched healthy controls
- Breast cancern = 25
- Healthy controlsn = 25reference
- Outcome
- Resting cardiac (phosphocreatine/gamma ATP) and skeletal muscle (Pi/phosphocreatine) energetics by 31P-magnetic resonance spectroscopy
- Follow-up
- Before and after chemotherapy
Methodological detailsprospective, observational, longitudinal
- Prospective
- Observational
- Longitudinal
Main finding
As reported in the abstract
after chemotherapy
- Breast cancer: cardiac phosphocreatine/gamma ATP ratio reduced (2.0±0.7 vs 1.1±0.5)
- P=0.001
- Breast cancer: skeletal muscle Pi/phosphocreatine ratio increased (0.1±0.1 vs 0.2±0.1)
- P=0.022
Further findings
Cardiac function and tissue characterization, biomarkers · after chemotherapy
- Increase in LV end-systolic volume
- P = 0.009
- Increase in LV end-diastolic volume
- P = 0.008
- Increase in T1 mapping
- P = 0.001
- Increase in T2 mapping
- P = 0.028
- Preserved LVEF, mass and global longitudinal strain; no change in cardiac biomarkers
Skeletal muscle biopsy structure · after chemotherapy
- Increase in areas of skeletal muscle degradation
- P = 0.001
- Reduction in skeletal muscle sarcomere number from prechemotherapy vs healthy controls
- P = 0.013
- Mitochondrial copy number preserved
Original publication
Impaired Cardiac and Skeletal Muscle Energetics Following Anthracycline Therapy for Breast Cancer. Circ Cardiovasc Imaging. Published 17 October 2023. doi:10.
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