Advanced Echocardiography Findings of HER2-Positive Breast Cancer Patients Following Anthracycline-Based Chemotherapy

Azin Alizadehasl; Mehrdad Haghazali; Hamed Bazrafshan Drissi; Amir Askarinejad; Seyed Amirhossein  Emami; Seyed Asadollah Mousavi; Mohammad Vaezi; Kamran Roudini; Robab Anbiaie; Payam Azadeh; Maedeh Barahman; Feridoun Noohi; Maryam Yazdani

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Advanced Echocardiography Findings of HER2-Positive Breast Cancer Patients Following Anthracycline-Based Chemotherapy

Author(s):

Azin Alizadehasl

¹,

Mehrdad Haghazali

²,

Hamed Bazrafshan Drissi

³,

Amir Askarinejad

²,

Seyed Amirhossein Emami

⁴,

Seyed Asadollah Mousavi⁴,

Mohammad Vaezi

⁵,

Kamran Roudini

⁶,

Robab Anbiaie

⁷,

Payam Azadeh⁷,

Maedeh Barahman

⁷,

Feridoun Noohi⁸,

Maryam Yazdani

^1,*

1Cardio-Oncology Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran

2Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran

3Department of Cardiology, Shiraz University of Medical Sciences, Shiraz, IR Iran

4Department of Hematology-Oncology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, IR Iran

5Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, IR Iran

6Department of Internal Medicine, School of Medicine Cancer Research Center Imam Khomeini Hospital Tehran University of Medical Sciences, Tehran, IR Iran

7Department of Radiation Oncology, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran

8Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran

International Cardiovascular Research Journal:Vol. 16, issue 3; e128445

Published online:Sep 30, 2022

Article type:Research Article

Received:May 23, 2022

Accepted:Nov 16, 2022

How to Cite:Alizadehasl A, Haghazali M, Bazrafshan Drissi H, Askarinejad A, Emami S A, et al. Advanced Echocardiography Findings of HER2-Positive Breast Cancer Patients Following Anthracycline-Based Chemotherapy.Int Cardiovasc Res J.2022;16(3):e128445.

Abstract

Background: Cardiotoxicity, a common complication of chemotherapy, may have irreversible adverse effects on the heart. Anthracycline-based chemotherapy for breast cancer can lead to dilation-hypokinetic cardiomyopathy, eventuating in heart failure. As the primary diagnostic tool for cardiovascular toxicity, echocardiography may be essential in evaluating the heart function of such patients.

Objectives: This study aimed to identify the most important echocardiography findings for proper and timely diagnosis of cardiotoxicity in patients with HER2-positive breast cancer undergoing anthracycline-based chemotherapy.

Methods: Our final analysis included 132 female patients who were HER2-positive and had breast cancer. All of these patients had one pre-chemotherapy echocardiography and at least one echocardiography after three episodes of anthracycline-based chemotherapy. The patients' age, body mass index, and history of chemotherapy were recorded. Mean alterations from baseline echocardiography to echocardiography after three episodes of chemotherapy were calculated for all parameters evaluated. Data analysis was conducted using the Statistical Package for the Social Sciences v. 26.

Results:

Significant changes were seen in three-dimensional left ventricular ejection fraction (LVEF 3D), two-dimensional left ventricular ejection fraction (LVEF 2D), left ventricular global circumferential strain (LVGCS), left ventricular global longitudinal strain (LVGLS), left ventricular end-diastolic volume (LVEDV), stroke volume (SV), left ventricular end-systolic volume (LVESV), right ventricular end-systolic dimension (RVESD) in patients with breast cancer (P < 0.0001). RVESD, LVESV, LVEDV, and SV significantly increased after three chemotherapy episodes, but LVEF (3D and 2D), absolute LVGCS, and absolute LVGLS fell significantly.

Conclusion:

LVEF (3D and 2D), LVGCS, LVGLS, LVEDV, LVESV, SV, and RVESD are important echocardiography parameters in diagnosing cardiotoxicity in patients with HER2-positive breast cancer.

Keywords

Cardiotoxicity

Echocardiography

Breast Neoplasms

Three-Dimensional Echocardiography

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