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dc.contributor.authorKimball, Ashlee
dc.contributor.authorPatil, Sanjana
dc.contributor.authorKoczwara, Bogda
dc.contributor.authorSree Raman, Karthigesh
dc.contributor.authorPerry, Rebecca Anne
dc.contributor.authorGrover, Suchi
dc.contributor.authorSelvanayagam, Joseph Brindaban
dc.date.accessioned2018-04-18T03:05:00Z
dc.date.available2018-04-18T03:05:00Z
dc.date.issued2018-03-08
dc.identifier.citationKimball, A., Patil, S., Koczwara, B., Raman, K. S., Perry, R., Grover, S., & Selvanayagam, J. (2018). Late characterisation of cardiac effects following anthracycline and trastuzumab treatment in breast cancer patients. International Journal of Cardiology, 261, 159–161. https:// doi.org/10.1016/j.ijcard.2018.03.025en
dc.identifier.issn0167-5273
dc.identifier.urihttp://hdl.handle.net/2328/37916
dc.description© 2018 Elsevier B.V.. This manuscript version is made available under the CC-BY-NC-ND 4.0 license: http://creativecommons.org/licenses/by-nc-nd/4.0/ This author accepted manuscript is made available following 12 month embargo from date of publication (March 2018) in accordance with the publisher’s archiving policyen
dc.description.abstractBackground Anthracycline (A) and trastuzumab (T) chemotherapy have well-recognized cardiac toxicity, potentially leading to significant morbidity and mortality. Our previous work in 46 prospectively enrolled breast cancer patients showed early left ventricular (LV) and right ventricular (RV) function decline at 1 and 3 months, but only persistent RV dysfunction at 12 months which correlated with myocardial oedema observed early (1 and 3 months) after administration of chemotherapy regimes. Method To investigate late cardiac effects, the same cohort were re-imaged with advanced Cardiovascular Magnetic Resonance (CMR) imaging including T1 mapping 5 ± 1 year post chemotherapy. Results Twenty-six out of 46 (50%) patients underwent follow-up imaging. A statistical but non-clinically significant decrease was observed in LV ejection fraction (EF) from baseline to 5 years (72.2 ± 6.6 to 65.4 ± 9.3, p < 0.005). Subjects with initial drop of LVEF by >10% at 3 months (n = 5) or at 12 months (n = 3) did not demonstrate any difference in LV or RVEF at 5 years. No correlation was observed between myocardial oedema and LV or RVEF at 5 years. At 5 years, T1 values were within normal limits overall (935 ± 48 ms). One patients had significantly elevated (>1000 ms) T1 values with no correlation to LV or RVEF. No subjects demonstrated replacement myocardial fibrosis at 5 years. Conclusion Using advanced CMR, contemporary chemotherapy regimes demonstrate minimal long-term cardiac toxicity. There is minimal diffuse and no replacement fibrosis as demonstrated by LGE, following chemotherapy. This study suggests limiting serial imaging in these patients at 12 months post chemotherapy.en
dc.language.isoen
dc.publisherElsevieren
dc.rights© 2018 Elsevier B.V..en
dc.subjectChemotherapyen
dc.subjectCardiotoxicityen
dc.subjectBreast canceren
dc.subjectCardiac magnetic resonance imagingen
dc.subjectT1-mappingen
dc.subjectLeft ventricular ejection fractionen
dc.titleLate characterisation of cardiac effects following anthracycline and trastuzumab treatment in breast cancer patientsen
dc.typeArticleen
dc.identifier.doihttps://doi.org/10.1016/j.ijcard.2018.03.025en
dc.rights.holderElsevier B.V..en
local.contributor.authorOrcidLookupPerry, Rebecca Anne: https://orcid.org/0000-0002-3333-3317en_US


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