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

authors:

avatar Azin Alizadehasl ORCID 1 , avatar Mehrdad Haghazali ORCID 2 , avatar Hamed Bazrafshan Drissi ORCID 3 , avatar Amir Askarinejad ORCID 2 , avatar Seyed Amirhossein Emami ORCID 4 , avatar Seyed Asadollah Mousavi 4 , avatar Mohammad Vaezi ORCID 5 , avatar Kamran Roudini ORCID 6 , avatar Robab Anbiaie ORCID 7 , avatar Payam Azadeh 7 , avatar Maedeh Barahman ORCID 7 , avatar Feridoun Noohi 8 , avatar Maryam Yazdani ORCID 1 , *

Cardio-Oncology Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran
Department of Cardiology, Shiraz University of Medical Sciences, Shiraz, IR Iran
Department of Hematology-Oncology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, IR Iran
Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, IR Iran
Department of Internal Medicine, School of Medicine Cancer Research Center Imam Khomeini Hospital Tehran University of Medical Sciences, Tehran, IR Iran
Department of Radiation Oncology, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
Cardiovascular 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: September 30, 2022
article type: Research Article
received: May 23, 2022
revised: July 31, 2022
accepted: November 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.

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References

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