2
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: not found

      Abnormalities in Three-Dimensional Left Ventricular Mechanics with Anthracycline Chemotherapy Are Associated with Systolic and Diastolic Dysfunction

      research-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Objectives:

          The objective of this study was to evaluate the changes in three-dimensional (3D) speckle-tracking echocardiography (STE)-derived measures of mechanics and their associations with systolic and diastolic dysfunction after anthracyclines.

          Background:

          An improved understanding of the changes in 3D cardiac mechanics with anthracyclines may provide important mechanistic insight and identify new metrics to detect cardiac dysfunction.

          Methods:

          142 women with breast cancer receiving doxorubicin (240 mg/m 2) with or without trastuzumab underwent 3D STE at standardized intervals prior to, during, and annually after chemotherapy. Left ventricular ejection fraction (LVEF), global circumferential strain (GCS), global longitudinal strain (GLS), principal strain, twist, and torsion were quantified. Linear regression analyses defined the associations between clinical factors and 3D parameters. Linear regression models with cluster robust variance estimators determined the associations between 3D measures and 2D LVEF and Doppler-derived E/e’ over time.

          Results:

          There were significant abnormalities in 3D LVEF, GCS, GLS, and principal strain post-doxorubicin as compared to controls (p<0.001). 3D parameters worsened post-anthracyclines and only partially recovered to baseline over a median of 2.1 years (interquartile range 1, 4). Higher blood pressure and body mass index were associated with worse post-anthracycline 3D GCS and GLS, respectively. All 3D measures were associated with 2D LVEF at the same visit; only 3D LVEF, GCS, GLS, and principal strain were associated with 2D LVEF at subsequent visits (p<0.05). In exploratory analyses, 3D LVEF and GCS were associated with subsequent systolic function independent of their corresponding 2D measures. 3D LVEF, GCS, principal strain, and twist were significantly associated with concurrent, but not subsequent, E/e’.

          Conclusions:

          Anthracyclines result in early and persistent abnormalities in 3D mechanics. 3D LVEF and strain measures are associated with concurrent and subsequent systolic dysfunction, and concurrent diastolic dysfunction. Future research is needed to define the mechanisms and clinical relevance of abnormal 3D mechanics.

          Related collections

          Author and article information

          Journal
          101467978
          35679
          JACC Cardiovasc Imaging
          JACC Cardiovasc Imaging
          JACC. Cardiovascular imaging
          1936-878X
          1876-7591
          18 June 2018
          14 March 2018
          August 2018
          01 August 2019
          : 11
          : 8
          : 1059-1068
          Affiliations
          [a ]Division of Cardiology, Barnes-Jewish Hospital, Saint Louis, Missouri. kwzhang@ 123456wustl.edu .
          [b ]Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois. brian.finkelman@ 123456northwestern.edu .
          [c ]Division of Cardiology, Tufts Medical Center, Boston, Massachusetts. gauravgulati42@ 123456gmail.com ; jupshaw@ 123456tuftsmedicalcenter.org
          [d ]Department of Pediatrics, Division of Cardiology, Rady Children’s Hospital San Diego, The University of California San Diego, San Diego, California. hnarayan@ 123456rchsd.org .
          [e ]Division of Hematology and Oncology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania. vivek.narayan@ 123456uphs.upenn.edu .
          [f ]Penn Cardiovascular Institute, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania. ted.plappert@ 123456gmail.com ; virginia.englefield@ 123456uphs.upenn.edu ; amanda.smith4@ 123456uphs.upenn.edu ; cazhang@ 123456sas.upenn.edu , bonnie.ky@ 123456uphs.upenn.edu
          [g ]Division of Cardiology, Wake Forest School of Medicine, Winston-Salem, North Carolina. ghundley@ 123456wakehealth.edu
          [h ]Center for Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania. bonnie.ky@ 123456uphs.upenn.edu
          Author notes
          [*]

          co-first authors

          Address for correspondence: Dr. Bonnie Ky, University of Pennsylvania School of Medicine, Smilow Center for Translational Research, 3400 Civic Center Blvd, Philadelphia, PA 19104., Telephone: (215) 573-6606, Fax: (215) 746-7415, bonnie.ky@ 123456uphs.upenn.edu
          Article
          PMC6417916 PMC6417916 6417916 nihpa950613
          10.1016/j.jcmg.2018.01.015
          6417916
          29550306
          f75a67f2-a263-4f0d-8084-3be5e166fdc7
          Categories
          Article

          3D echocardiography, anthracyclines, cardio-oncology

          Comments

          Comment on this article