Anthracycline Therapy Induces an Early Decline of Cardiac Contractility in Low-Risk Patients with Breast Cancer

Fabian Voß,Fabian Nienhaus, Saskia Pietrucha,Eugen Ruckhäberle,Tanja FehmTop Scholar, Tobias Melz,Mareike Cramer,Sebastian M. Haberkorn,Ulrich Flögel,Ralf Westenfeld,Daniel Scheiber,Christian JungTop Scholar,Malte KelmTop Scholar,Amin Polzin,Florian Bönner

Cardio-Oncology（2024）

University Hospital Düsseldorf

Cited 0|Views46

Abstract

Cancer therapy-related cardiac dysfunction (CTRCD) is a dreaded complication of anthracycline therapy. CTRCD most frequently appears in patients with cardiovascular risk factors (CVR) or known cardiovascular disease. However, limited data exist on incidence and course of anthracycline-induced CTRCD in patients without preexisting risk factors. We therefore aimed to longitudinally investigate a cohort of young women on anthracycline treatment due to breast cancer without cardiovascular risk factors or known cardiovascular disease (NCT03940625). We enrolled 59 women with primary breast cancer and scheduled anthracycline-based therapy, but without CVR or preexisting cardiovascular disease. We conducted a longitudinal assessment before, immediately and 12 months after cancer therapy with general laboratory, electrocardiograms, echocardiography and cardiovascular magnetic resonance (CMR), including myocardial relaxometry with T1, T2 and extracellular volume mapping. Every single patient experienced a drop in CMR-measured left ventricular ejection fraction (LVEF) of 6 ± 3 = high sensitive Troponin T, NT-pro BNP = NT-pro brain natriuretic peptide

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Key words

Breast cancer,Anthracyclines,Cardiotoxicity,Myocardial damage,CMR

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【要点】：该论文发现即使是低风险的乳腺癌患者，在接受阿霉素治疗后也会早期出现心脏收缩功能的下降，这一发现拓宽了对蒽环类药物相关心脏功能障碍的认识，强调了在没有心血管风险因素的患者中也需要关注心脏毒性。

【方法】：通过纵向研究，对59名因乳腺癌接受蒽环类药物化疗的年轻女性进行追踪评估，这些患者没有心血管风险因素或已知的心血管疾病。

【实验】：实验使用常规实验室检查、心电图、超声心动图和心血管磁共振成像（CMR），包括通过T1、T2和细胞外体积映射的心肌松弛度评估，在化疗前、化疗后立即和化疗后12个月进行。研究发现每个患者的心脏磁共振成像测量的左室射血分数（LVEF）都出现了下降，与高敏感性TnT、NT-pro BNP（N末端B型钠尿肽前体）水平升高相关。

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