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Cited by 242

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Subclinical anthracycline- and trastuzumab-induced cardiotoxicity in the long-term follow-up of asymptomatic breast cancer survivors: a speckle tracking echocardiographic study

Ho, Emily, Brown, Angela, Barrett, Patrick, Morgan, Roisin B, King, Gerard, Kennedy, M John, Murphy, Ross T·2010·Heart

Abstract

Objective: To examine the long-term effects of standard chemotherapy on myocardial function in asymptomatic breast cancer survivors using two-dimensional speckle tracking echocardiography. Methods: Seventy women (chemotherapy group) aged 54±8 years who had received anthracycline treatment with (n=19) or without (n=51) adjuvant trastuzumab up to 6 years previously, and 50 female controls were studied. Left ventricular systolic (ejection fraction (EF%), peak systolic myocardial excursion, (Sm)) and diastolic (peak mitral E and A velocities, six-point average of mitral annular E′ velocities) function, 2D global and regional longitudinal and radial strain were determined using standard 2D Doppler and tissue Doppler echocardiographic methods and speckle tracking software. Results: Despite normal EF% (62±4% vs 60±3%, p=0.051) the chemotherapy group had reduced E/A ratios (0.9±0.3 vs 1.1±0.3, p=0.003), global E′ (10.2±2 vs 11.2±2.3, p=0.036), global Sm (9.0±1.3 vs 9.6±1.3, p=0.029) and global longitudinal 2D strain (−18.1±2.2 vs −19.6±1.8, p=0.0001) in comparison with controls. In 18 (26%) of the chemotherapy group, global longitudinal strain was below the lower limit of the control group. Cigarette smoking was a negative predictor of longitudinal strain, but only in the chemotherapy group. Radial strain did not differ significantly between the two groups. There were no significant differences in EF%, global Sm and longitudinal strain between trastuzumab-treated individuals and controls. Conclusions: Subclinical systolic and diastolic myocardial abnormalities were present in asymptomatic breast cancer survivors up to 6 years after standard chemotherapy. Cigarette smoking had a negative effect on longitudinal strain in these individuals. Adjuvant trastuzumab treatment did not appear to have an additive adverse impact on myocardial function in the medium–long term.

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Metadata

Authors
Ho, E., Brown, A., Barrett, P., Morgan, R. B., King, G., Kennedy, M. J., & Murphy, R. T.
Venue
Heart
Publisher
BMJ
Published
2010-04-27
Volume
96
Issue
9
Pages
701-707
ISSN
  • 1355-6037 (ISSN-L)
  • 1468-201X
OpenAlex
W2170514599
Cited by
242
References
2
FWCI
12.06
Type
journal article
Language
en
Open access
closed

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CoChat. (2026). Citation check: Subclinical anthracycline- and trastuzumab-induced cardiotoxicity in the long-term follow-up of asymptomatic breast cancer survivors: a speckle tracking echocardiographic study. https://app.cochat.ai/papers/10.1136/hrt.2009.173997
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Ho, E., Brown, A., Barrett, P., Morgan, R. B., King, G., Kennedy, M. J., & Murphy, R. T. (2010). Subclinical anthracycline- and trastuzumab-induced cardiotoxicity in the long-term follow-up of asymptomatic breast cancer survivors: a speckle tracking echocardiographic study. Heart. https://doi.org/10.1136/hrt.2009.173997

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