Usefulness of Cardiac Magnetic Resonance for Early Detection of Cancer Therapeutics-Related Cardiac Dysfunction in Breast Cancer Patients

22 Pages Posted: 27 May 2022

See all articles by Yosuke Terui

Yosuke Terui

Tohoku University - Graduate School of Medicine

Koichiro Sugimura

Tohoku University - Graduate School of Medicine

Hideki Ota

Tohoku University - Graduate School of Medicine

Hiroshi Tada

Tohoku University - Department of Breast and Endocrine Surgical Oncology

Kotaro Nochioka

Tohoku University - Graduate School of Medicine

Haruka Sato

Tohoku University - Graduate School of Medicine

Yuko Katsuta

Tohoku University - Graduate School of Medicine

Junko Fujiwara

Tohoku University - Tohoku University Hospital

Narumi Harada-Shoji

Tohoku University - Graduate School of Medicine

Akiko Sato-Tadano

Tohoku University - Graduate School of Medicine

Yoshiaki Morita

Tohoku University - Graduate School of Medicine

Wenyu Sun

Tohoku University - Graduate School of Medicine

Satoshi Higuchi

Tohoku University - Graduate School of Medicine

Shunsuke Tatebe

Tohoku University - Graduate School of Medicine

Shigefumi Fukui

Tohoku University - Graduate School of Medicine

Saori Miyamichi-Yamamoto

Tohoku University - Graduate School of Medicine

Hideaki Suzuki

Tohoku University - Graduate School of Medicine

Nobuhiro Yaoita

Tohoku University - Graduate School of Medicine

Nobuhiro Kikuchi

Tohoku University - Graduate School of Medicine

Miku Sakota

Tohoku University - Graduate School of Medicine

Satoshi Miyata

Tohoku University - Graduate School of Medicine

Yasuhiko Sakata

Tohoku University - Graduate School of Medicine

Takanori Ishida

Tohoku University - Graduate School of Medicine

Kei Takase

Tohoku University - Graduate School of Medicine

Satoshi Yasuda

Tohoku University, Graduate School of Medicine, Department of Cardiovascular Medicine; National Cerebral and Cardiovascular Centre - Department of Cardiovascular Medicine; Tohoku University - Graduate School of Medicine

Hiroaki Shimokawa

Tohoku University, Graduate School of Medicine, Department of Cardiovascular Medicine; Tohoku University - Graduate School of Medicine

Abstract

Background: Prognosis of breast cancer patients has been improved along with the progress in cancer therapies. However, cancer therapeutics-related cardiac dysfunction (CTRCD) has been an emerging issue.  For early detection of CTRCD, we examined whether native T1 mapping and global longitudinal strain (GLS) using cardiac magnetic resonance (CMR) and biomarkers analysis are useful.

Methods: We prospectively enrolled 83 consecutive chemotherapy-naïve female patients with breast cancer (mean age, 56±13 yrs.) between 2017 and 2020.  CTRCD was defined based on echocardiography as left ventricular ejection fraction (LVEF) below 53% at any follow-up period with LVEF>10% points decrease from baseline after chemotherapy.  To evaluate cardiac function, CMR (at baseline and 6 months), 12-lead ECG, echocardiography, and biomarkers (at baseline and every 3 months) were evaluated.

Results: A total of 164 CMRs were performed in 83 patients.  LVEF and GLS were significantly decreased after chemotherapy (LVEF, from 71.2±4.4 to 67.6±5.8%; GLS, from -27.9±3.9 to -24.7±3.5%, respectively, both P<0.01). Native T1 value also significantly elevated after chemotherapy (from 1283±36 to 1308±39 msec, P<0.01).  Among the 83 patients, 7 (8.4%) developed CTRCD.  Of note, native T1 value before chemotherapy was significantly higher in patients with CTRCD than in those without it (1352±29 vs. 1278±30 msec, P<0.01).  The multivariable logistic regression analysis revealed that native T1 value was an independent predictive factor for the development of CTRCD [OR 2.33; 95%CI 1.15-4.75, P=0.02].

Conclusions: These results indicate that CMR is useful to detect chemotherapy-related myocardial damage and predict for the development of CTRCD in breast cancer patients.

Note:
Funding Information: This study was supported by grants-in-aid from Japan Agency for Medical Research and Development (Tokyo, Japan) (19ek0210084h0003).

Declaration of Interests: None.

Ethics Approval Statement: This study was conducted following the ethical principles in the Declaration of Helsinki and the protocol approved by the Ethics Committee of Tohoku University Graduate School of Medicine (No.2017-1-866). (No.2017-1-866). All participants provided a written informed consent.

Keywords: Cardio-OncologyCancer therapeutics-related Cardiac DysfunctionBreast CancerCardiac Magnetic ResonanceNative T1 mapping

Suggested Citation

Terui, Yosuke and Sugimura, Koichiro and Ota, Hideki and Tada, Hiroshi and Nochioka, Kotaro and Sato, Haruka and Katsuta, Yuko and Fujiwara, Junko and Harada-Shoji, Narumi and Sato-Tadano, Akiko and Morita, Yoshiaki and Sun, Wenyu and Higuchi, Satoshi and Tatebe, Shunsuke and Fukui, Shigefumi and Miyamichi-Yamamoto, Saori and Suzuki, Hideaki and Yaoita, Nobuhiro and Kikuchi, Nobuhiro and Sakota, Miku and Miyata, Satoshi and Sakata, Yasuhiko and Ishida, Takanori and Takase, Kei and Yasuda, Satoshi and Shimokawa, Hiroaki, Usefulness of Cardiac Magnetic Resonance for Early Detection of Cancer Therapeutics-Related Cardiac Dysfunction in Breast Cancer Patients. Available at SSRN: https://ssrn.com/abstract=4116273 or http://dx.doi.org/10.2139/ssrn.4116273

Yosuke Terui

Tohoku University - Graduate School of Medicine ( email )

Koichiro Sugimura

Tohoku University - Graduate School of Medicine ( email )

Hideki Ota

Tohoku University - Graduate School of Medicine ( email )

Hiroshi Tada

Tohoku University - Department of Breast and Endocrine Surgical Oncology ( email )

Sendai
Japan

Kotaro Nochioka

Tohoku University - Graduate School of Medicine ( email )

Haruka Sato

Tohoku University - Graduate School of Medicine ( email )

Yuko Katsuta

Tohoku University - Graduate School of Medicine ( email )

Junko Fujiwara

Tohoku University - Tohoku University Hospital ( email )

Narumi Harada-Shoji

Tohoku University - Graduate School of Medicine ( email )

Akiko Sato-Tadano

Tohoku University - Graduate School of Medicine ( email )

Yoshiaki Morita

Tohoku University - Graduate School of Medicine ( email )

Wenyu Sun

Tohoku University - Graduate School of Medicine ( email )

Satoshi Higuchi

Tohoku University - Graduate School of Medicine ( email )

Shunsuke Tatebe

Tohoku University - Graduate School of Medicine ( email )

Shigefumi Fukui

Tohoku University - Graduate School of Medicine ( email )

Saori Miyamichi-Yamamoto

Tohoku University - Graduate School of Medicine ( email )

Hideaki Suzuki

Tohoku University - Graduate School of Medicine ( email )

Nobuhiro Yaoita

Tohoku University - Graduate School of Medicine ( email )

Nobuhiro Kikuchi

Tohoku University - Graduate School of Medicine ( email )

Miku Sakota

Tohoku University - Graduate School of Medicine ( email )

Satoshi Miyata

Tohoku University - Graduate School of Medicine ( email )

Yasuhiko Sakata

Tohoku University - Graduate School of Medicine ( email )

Takanori Ishida

Tohoku University - Graduate School of Medicine ( email )

Kei Takase

Tohoku University - Graduate School of Medicine ( email )

Satoshi Yasuda

Tohoku University, Graduate School of Medicine, Department of Cardiovascular Medicine ( email )

National Cerebral and Cardiovascular Centre - Department of Cardiovascular Medicine ( email )

Suita
Japan

Tohoku University - Graduate School of Medicine ( email )

Hiroaki Shimokawa (Contact Author)

Tohoku University, Graduate School of Medicine, Department of Cardiovascular Medicine ( email )

Tohoku University - Graduate School of Medicine ( email )

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