Subclinical Myocardial Impairment Occurred in Septal and Anterior LV Wall Segments After Anthracycline-Embedded Chemotherapy and did not Worsen During Adjuvant Trastuzumab Treatment in Breast Cancer Patients

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• 作者：Stefan Andreas Lange ; Jens Jung ; Almut Jaeck ; Thomas Hitschold…
• 关键词：Anthracyclines ; Cardiomyopathy ; Breast cancer ; 2D echocardiography
• 刊名：Cardiovascular Toxicology
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：16
• 期：2
• 页码：193-206
• 全文大小：4,510 KB
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• 作者单位：Stefan Andreas Lange (1)
  Jens Jung (2)
  Almut Jaeck (3)
  Thomas Hitschold (4)
  Bernd Ebner (5)
  
  1. Asklepios-Harz-Klinik Goslar, Medizinische Klinik I, Kardiologie, Angiologie, Diabetologie und Internistische Intensivmedizin, Koesliner Str. 12, 38640, Goslar, Germany
  2. Medizinische Klinik I, Kardiologie und Angiologie, Klinikum Worms, Akademisches Lehrkrankenhaus der Johannes–Gutenberg–Universitaet, Gabriel-von-Seidl-Str. 81, Mainz, Germany
  3. Zentrale Krankenhausapotheke, Harzklinikum D. C. Erxleben, Akademisches Lehrkrankenhaus der Otto-von-Guericke Universitaet Magdeburg, Ilsenburger Str. 15, Wernigerode, Germany
  4. Frauenklinik, Brustzentrum-Perinatalzentrum, Klinikum Worms, Akademisches Lehrkrankenhaus der Johannes–Gutenberg–Universitaet, Gabriel-von-Seidl-Str. 81, Mainz, Germany
  5. Medizinische Klinik/Kardiologie, Herzzentrum Dresden, Universitaetsklinik, Technische Universitaet Dresden, Fetscherstr. 76, Dresden, Germany
  
• 刊物主题：Pharmacology/Toxicology; Cardiology;
• 出版者：Springer US
• ISSN：1559-0259

文摘

In a previous study of breast cancer patients, we found changes in cardiac function and size during the early stages of adjuvant trastuzumab (Herceptin®) therapy. Here we present a subgroup analysis of this patient cohort. This subgroup received a anthracycline-embedded chemotherapy followed by at least 3 months up to 6 months of adjuvant Herceptin® therapy. Twenty-seven female breast cancer patients with Her-2/-neu overexpression were studied using conventional echocardiography and 2D speckle tracking. These methods were done before anthracycline-embedded chemotherapy, before adjuvant trastuzumab therapy, and both 3 and 6 months after the start of the therapy (T3, T6). The LV–EF (Simpson biplane) decreased significantly from before the chemotherapy to after the chemotherapy and further decreased after 3 months of trastuzumab therapy (66.2 ± 1.5 vs. 58.7 ± 1.2 vs. 55.6 ± 1.3 vs. 55.9 ± 1.5 %; p < 0.05). The stroke volume index remained constant after chemotherapy (22.0 ± 0.8 vs. 22.6 ± 1.3 ml/m2; p = 0.9), but increased significantly during trastuzumab therapy (26.7 ± 1.1 and 27.3 ± 1.0 ml/m2; p < 0.01). Global longitudinal strain exclusively decreased during chemotherapy (−21.0 ± 0.5 vs. −18.9 ± 0.5 %, p < 0.001). Regional longitudinal strain decreased significantly after chemotherapy in septal, anteroseptal, anterolateral, and apex segments. Mitral valve regurgitation increased during the whole treatment, but especially during trastuzumab. Right ventricular function decreased exclusively during chemotherapy. Anthracycline-embedded chemotherapy in patients with breast cancer led to a decrease in LV function, especially of the septal and anterior segments, and did not worsen during adjuvant trastuzumab treatment.