Longitudinal Evaluation of Coronary Arteries and Myocardium in Breast Cancer Using Coronary Computed Tomographic Angiography

Tu, C; Shen, H; Li, X; Wang, X; Miao, Z; Deng, W; Liu, R; Lan, X; Chen, H; Zhang, J

doi:10.1016/j.jcmg.2024.05.017

Cardio-oncology & other

Longitudinal Evaluation of Coronary Arteries and Myocardium in Breast Cancer Using Coronary Computed Tomographic Angiography

JACC Cardiovasc ImagingPublished 10 Jul 2024Prospective cohort study

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Authors' conclusion

Multiparameter coronary CTA contributes to comprehensive assessment of the coronary arteries and myocardium in patients with left BC receiving anthracycline with or without radiotherapy. Baseline coronary artery stenosis and CT-FFR might be imaging markers for predicting CTRCD in these patients.

Study context

Population: Patients with left breast cancer receiving anthracycline with or without radiotherapy, coronary computed tomography angiography (CTA) before and after treatment
Participants: 80 vs 59

Exposure: Anthracycline with radiotherapy vs anthracycline alone; baseline coronary CTA parameters and cancer therapy-related cardiac dysfunction (CTRCD)
Anthracyclinen = 80reference
Anthracycline with radiotherapyn = 59
Outcome: Association of baseline coronary CTA parameters with CTRCD (multivariable logistic regression)

Main finding

As reported in the abstract

Adjusted for HFA-ICOS risk

Odds ratio (95% CI)P value

Baseline LAD stenosis

1.987(1.322–2.768)

P = 0.021

Baseline LCX stenosis

1.895(1.281–2.802)

P = 0.031

Baseline RCA stenosis

1.920(1.405–2.811)

P = 0.028

Baseline CT-FFR of LAD

3.425(1.621–9.434)

P < 0.001

Baseline CT-FFR of LCX

2.058(1.030–5.076)

P = 0.006

Baseline CT-FFR of RCA

2.469(1.232–6.944)

P = 0.004

Participants developing CTRCD: 24

Observational data: associations, not effects.

Further findings

Change in computed tomographic fractional flow reserve (CT-FFR), pericoronary adipose tissue (PCAT) CT attenuation and left ventricular (LV) extracellular volume (ECV) after treatment

CT-FFR decreased; PCAT CT attenuation and LV global and segments' ECV increased after treatment: all P < 0.05
After chemoradiotherapy, CT-FFR lower and PCAT CT attenuation and LV myocardial ECV higher than after chemotherapy

Original publication

Longitudinal Evaluation of Coronary Arteries and Myocardium in Breast Cancer Using Coronary Computed Tomographic Angiography. JACC Cardiovasc Imaging. Published 10 July 2024. doi:10.1016/j.jcmg.2024.05.017

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