ArticleNuclear medicine communications2019
Diastolic dysfunction can precede systolic dysfunction on MUGA in cancer patients receiving trastuzumab-based therapy.
Article in Nuclear medicine communications, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 28 citations in OpenAlex.
- Cardiac magnetic resonance imaging in the assessment of cardiac injury and toxicity from cancer-related chemotherapy.Pediatric radiology · 2025Review
- Review
- HER2-Targeted Therapy-From Pathophysiology to Clinical Manifestation: A Narrative Review.Journal of cardiovascular development and disease · 2023Review
- Syndromes of Concurrent Hypertension, Diastolic Dysfunction, and Pulmonary or Peripheral Edema in Cardio-Oncology: Case Studies, Literature Review, and New Classification System.Current treatment options in oncology · 2023Review
- Early prediction of chemotherapy-induced cardiotoxicity.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2023Article
- Early detection of cancer therapy cardiotoxicity by radionuclide angiography: An update.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2023Review
- Tales from the future-nuclear cardio-oncology, from prediction to diagnosis and monitoring.European heart journal. Cardiovascular Imaging · 2023Review
- Prevalence of cancer therapy cardiotoxicity as assessed by imaging procedures: A scoping review.Cancer medicine · 2023Article
- Equilibrium radionuclide angiography: Intra- and inter-observer repeatability and reproducibility in the assessment of cardiac systolic and diastolic function.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2021Article
- Longitudinal diastolic strain slope as an early sign for systolic dysfunction among patients with active cancer.Clinical research in cardiology : official journal of the German Cardiac Society · 2021Article
- Diastolic assessment by CZT-SPECT: Could it be the next best thing for the detection of subclinical chemotherapy-induced cardiotoxicity?Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2020Article
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Authors and funding
6 authors at 4 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTrastuzumab (T) and anthracycline (A)-based chemotherapy is considered the standard of care in human epidermal growth factor receptor-2+ overexpressing breast cancer, but requires monitoring for known cardiotoxicity using left ventricular (LV) ejection fraction (EF) every 3-4 months during treatment. It is not conclusively established whether diastolic dysfunction (DD) precedes LVEF decrease in patients developing trastuzumab-induced cardiotoxicity (TIC).
objectiveThe aim was to elucidate whether DD precedes LVEF decrease in trastuzumab-treated patients being monitored with radionuclide multigated acquisition for TIC. PATIENTS AND
methodsPatients treated with T±A-based chemotherapy who had undergone multigated acquisition were selected by date range (January 2006-September 2015). Up to four scans were analyzed per patient: (a) pre-A therapy, (b) pre-T therapy, (c) 4 months into T therapy, and (d) at end of T therapy. Baseline referred to the first scan of each patient (i.e. pre-A or pre-T). LV systolic and DD were defined as follows: EF less than 50% or a 10-point decrease from baseline and LV peak filling rate (PFR) less than 2.5 end-diastolic volume/s and time to peak LV filling rates (TPFR) greater than 180 ms, respectively.
resultsA total of 202 patients were screened for this study, of whom 153 had received A therapy (5.1±4.1 months duration) before T, 192 had 4 months of follow-up data, and 146 had 4 months of follow-up data and beyond (10.5±5.0 months). LVEF decreased with A and T therapy (P<0.005), but remained stable between 4 months and the final exam (P=0.26). In patients with normal diastolic function at baseline (45.5%), PFR decreased with A and T, and DD preceded SD by 73 days on average. In the remaining patients, with abnormal diastolic function at baseline (54.5%), PFR did not change over the course of treatment (P>0.1), nor did TPFR (P>0.3).
conclusionPatients with normal diastolic function at baseline receiving trastuzumab±anthracycline adjuvant therapy may develop DD before SD, therefore offering an opportunity for early referral to cardiologists to optimize cardiovascular risk factors and manage cardiotoxicity.
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