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Assessment of Echocardiography and Biomarkers for the Extended Prediction of Cardiotoxicity in Patients Treated With Anthracyclines, Taxanes, and Trastuzumab

Open access
Sawaya, Heloisa, Sebag, Igal A., Plana, Juan Carlos, Januzzi, James L., Ky, Bonnie, Tan, Timothy C., Cohen, Victor, Banchs, Jose, Carver, Joseph R., Wiegers, Susan E., Martin, Randolph P., Picard, Michael H., Gerszten, Robert E., Halpern, Elkan F., Passeri, Jonathan, Kuter, Irene, Scherrer-Crosbie, Marielle·2012·Circulation: Cardiovascular Imaging

Abstract

Background—: Because cancer patients survive longer, the impact of cardiotoxicity associated with the use of cancer treatments escalates. The present study investigates whether early alterations of myocardial strain and blood biomarkers predict incident cardiotoxicity in patients with breast cancer during treatment with anthracyclines, taxanes, and trastuzumab. Methods and Results—: Eighty-one women with newly diagnosed human epidermal growth factor receptor 2–positive breast cancer, treated with anthracyclines followed by taxanes and trastuzumab were enrolled to be evaluated every 3 months during their cancer therapy (total of 15 months) using echocardiograms and blood samples. Left ventricular ejection fraction, peak systolic longitudinal, radial, and circumferential myocardial strain were calculated. Ultrasensitive troponin I, N-terminal pro–B-type natriuretic peptide, and the interleukin family member (ST2) were also measured. Left ventricular ejection fraction decreased (64 ± 5% to 59 ± 6%; P <0.0001) over 15 months. Twenty-six patients (32%, [22%–43%]) developed cardiotoxicity as defined by the Cardiac Review and Evaluation Committee Reviewing Trastuzumab; of these patients, 5 (6%, [2%–14%]) had symptoms of heart failure. Peak systolic longitudinal myocardial strain and ultrasensitive troponin I measured at the completion of anthracyclines treatment predicted the subsequent development of cardiotoxicity; no significant associations were observed for left ventricular ejection fraction, N-terminal pro–B-type natriuretic peptide, and ST2. Longitudinal strain was <19% in all patients who later developed heart failure. Conclusions—: In patients with breast cancer treated with anthracyclines, taxanes, and trastuzumab, systolic longitudinal myocardial strain and ultrasensitive troponin I measured at the completion of anthracyclines therapy are useful in the prediction of subsequent cardiotoxicity and may help guide treatment to avoid cardiac side-effects.

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Metadata

Authors
Sawaya, H., Sebag, I. A., Plana, J. C., Januzzi, J. L., Ky, B., Tan, T. C., Cohen, V., Banchs, J., Carver, J. R., Wiegers, S. E., Martin, R. P., Picard, M. H., Gerszten, R. E., Halpern, E. F., Passeri, J., Kuter, I., & Scherrer-Crosbie, M.
Venue
Circulation: Cardiovascular Imaging
Published
2012-09
Volume
5
Issue
5
Pages
596-603
ISSN
  • 1941-9651 (ISSN-L)
  • 1942-0080
OpenAlex
W2154066911
Cited by
814
References
1
FWCI
29.16
Type
journal article
Language
en
Open access
green

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CoChat. (2026). Citation check: Assessment of Echocardiography and Biomarkers for the Extended Prediction of Cardiotoxicity in Patients Treated With Anthracyclines, Taxanes, and Trastuzumab. https://app.cochat.ai/papers/10.1161/circimaging.112.973321
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Sawaya, H., Sebag, I. A., Plana, J. C., Januzzi, J. L., Ky, B., Tan, T. C., Cohen, V., Banchs, J., Carver, J. R., Wiegers, S. E., Martin, R. P., Picard, M. H., Gerszten, R. E., Halpern, E. F., Passeri, J., Kuter, I., & Scherrer-Crosbie, M. (2012). Assessment of Echocardiography and Biomarkers for the Extended Prediction of Cardiotoxicity in Patients Treated With Anthracyclines, Taxanes, and Trastuzumab. Circulation: Cardiovascular Imaging. https://doi.org/10.1161/circimaging.112.973321

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

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