Echocardiography for the diagnosis of CTRCD in women with early-stage breast cancer

JAMAEsmaeilzadeh M, Fresno CMU, Somerset E, et al. | February 11, 2022


In clinical practice, timely diagnosis of cancer therapy–related cardiac dysfunction (CTRCD) could be improved via combined use of echocardiography 3-dimensional (3-D) left ventricular ejection fraction (LVEF), global longitudinal strain (GLS), and global circumferential strain (GCS).

  • Researchers assessed the correctness of an algorithm employing echocardiography and serum biomarkers for the timely diagnosis of CTRCD defined using cardiovascular magnetic resonance (CMR).

  • In this cohort study, a total of 136 women (mean [SD] age, 51.1 [9.2] years) with human epidermal growth factor receptor 2–positive early-stage breast cancer were included.

  • Exposures included sequential therapy with anthracyclines and trastuzumab.

  • Good discriminatory accuracy for concurrent CMR-detected CTRCD was achieved with a combined approach of using echocardiographic 3-D LVEF, GLS, and GCS, but not by high-sensitivity troponin I and B-type natriuretic.

  • The likelihood of CTRCD as defined by CMR was 1.0% when none of the 3-D LVEF, GLS, and GCS CTRCD criteria were met.

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