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Title: Strain rate imaging detects early cardiac effects of pegylated liposomal doxorubicin as adjuvant therapy in elderly patients with breast cancer
Authors: Jurcut, Ruxandra
Wildiers, Hans
Ganame, Javier
D'hooge, Jan
De Backer, J
Denys, H
Paridaens, Robert
Rademakers, Frank
Voigt, Jens-Uwe # ×
Issue Date: Dec-2008
Publisher: Mosby, Inc.
Series Title: Journal of the American Society of Echocardiography vol:21 issue:12 pages:1283-1289
Abstract: Objective: Cardiac toxicity remains an important side effect of anthracyclines. New drug formulations (e.g., pegylated liposomal doxorubicin [PL-DOX]) seem to be a successful strategy for reducing it. Changes in cardiac function induced by early chemotherapy, however, are subtle and difficult to quantitate by conventional imaging methods. Doppler myocardial imaging based velocity, strain and strain rate measurements have been shown to sensitively quantify abnormalities in cardiac function in other settings.
Design: We evaluated the feasibility and sensitivity of strain rate imaging compared with conventional echocardiography in detecting cardiac effects of PL-DOX therapy in elderly patients with cancer. In a pilot study, we examined 16 elderly women (age 69.8 +/- 3.1 years) with breast cancer receiving 6 cycles of PL-DOX. Conventional and Doppler myocardial imaging echocardiography were obtained at baseline and after 3 and 6 cycles of treatment. Segmental peak systolic longitudinal and radial velocity, strain and strain rate were measured.
Results: Left ventricular dimensions, ejection fraction and systolic myocardial velocity did not change throughout the follow-up. In contrast, a significant reduction in longitudinal and radial strain and strain rate was found after 6 cycles (longitudinal strain - 18.8% +/- 2.8% vs - 22.7% +/- 2.8%, P < .001 vs baseline). Changes in radial function appeared earlier and were more pronounced than in longitudinal direction.
Conclusion: In contrast with conventional echocardiography and myocardial velocity measurements, myocardial deformation parameters allowed detecting subtle changes in longitudinal and radial left ventricular function after 6 cycles of PL-DOX. We suggest that Doppler-based myocardial deformation imaging should be used for cardiac function monitoring during chemotherapy.
ISSN: 0894-7317
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Experimental Cardiology
Laboratory of Experimental Oncology
Cardiovascular Imaging and Dynamics
Cardiology
× corresponding author
# (joint) last author

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