Evidence map›Paper›PMID 31042319›Full record

ArticleCancer2019

Detailed phenotyping reveals distinct trajectories of cardiovascular function and symptoms with exposure to modern breast cancer therapy.

Biniyam G Demissei, Brian S Finkelman, Rebecca A Hubbard, Liyong Zhang, Amanda M Smith, Karyn Sheline, Caitlin McDonald, Hari K Narayan, Vivek Narayan, Adam J Waxman and 10 more

Abstract read
In one paragraph

Article in Cancer, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Guideline
  2. Review
  3. Review
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Biniyam G DemisseiDivision of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.ORCID 0000-0003-0875-4985
Brian S FinkelmanDepartment of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Rebecca A HubbardDepartment of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Liyong ZhangDivision of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Amanda M SmithDivision of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Karyn ShelineDivision of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Caitlin McDonaldDivision of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Hari K NarayanDivision of Cardiology, Department of Pediatrics, Rady Children's Hospital-San Diego, The University of California at San Diego, San Diego, California.ORCID 0000-0001-5180-2204
Vivek NarayanDivision of Hematology and Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Adam J WaxmanDivision of Hematology and Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Susan M DomchekDivision of Hematology and Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Angela DeMicheleDivision of Hematology and Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Payal ShahDivision of Hematology and Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Amy S ClarkDivision of Hematology and Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Angela R BradburyDivision of Hematology and Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.ORCID 0000-0001-9607-6402
Joseph R CarverDivision of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Jenica UpshawDivision of Cardiology, Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts.
Saro H ArmenianDepartment of Population Sciences, City of Hope, Duarte, California.ORCID 0000-0003-2604-8603
Peter LiuDivision of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Bonnie KyDivision of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.

Funding

Multimarker Risk Prediction in Cancer Therapy CardiotoxicityR01HL118018 · NHLBI · UNIVERSITY OF PENNSYLVANIA · PI KY, BONNIE · 2014 to 2018
$3.7M
The Role of Neuregulin in Human Cardiac Remodeling and Heart FailureK23HL095661 · NHLBI · UNIVERSITY OF PENNSYLVANIA · PI KY, BONNIE · 2010 to 2014
$704k
Markers of Oxidative and Nitrosative Stress in Anthracycline Cardiotoxicity and Statin CardioprotectionR21HL141802 · NHLBI · UNIVERSITY OF PENNSYLVANIA · PI KY, BONNIE · 2018 to 2019
$469k
NHLBI NIH HHS K23 HL095661NHLBI NIH HHS R01 HL118018NHLBI NIH HHS R21 HL141802
6 · The paper itself

Abstract

backgroundBreast cancer therapies are associated with a risk of cardiac dysfunction, most commonly defined by changes in left ventricular ejection fraction (LVEF). Recently, the authors identified 3 classes of LVEF change after exposure to anthracyclines and/or trastuzumab using latent class growth modeling. The objective of the current study was to characterize the clinical, biochemical, and functional profiles associated with LVEF trajectory class membership.

methodsTransthoracic echocardiography and biomarker assessments were performed and questionnaires were administered at standardized intervals in a longitudinal cohort of 314 patients with breast cancer who were treated with anthracyclines and/or trastuzumab. Univariable and multivariable multinomial regression analyses evaluated associations between baseline variables and LVEF trajectory class membership. Generalized estimating equations were used to define mean changes in cardiovascular measures over time within each class.

resultsAmong the 3 distinct subgroups of LVEF changes identified (stable [class 1]; modest, persistent decline [class 2]; and significant early decline followed by partial recovery [class 3]), higher baseline LVEF, radiotherapy, and sequential therapy with anthracyclines and/or trastuzumab were associated with class 2 or 3 membership. Sustained abnormalities in longitudinal strain and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were observed in patients in class 2, as were heart failure symptoms. Similar abnormalities were observed in patients in class 3, but there was a trend toward recovery, particularly for longitudinal strain.

conclusionsPatients with modest, persistent LVEF declines experienced sustained abnormalities in imaging and biochemical markers of cardiac function and heart failure symptoms. Further investigation is needed to characterize the long-term risk of heart failure, particularly in those with modest LVEF declines.

Indexed as

AdultAntineoplastic Combined Chemotherapy ProtocolsBiomarkersBreast NeoplasmsEchocardiographyFemaleHeart FailureHumansIncidenceMiddle AgedNatriuretic Peptide, BrainPeptide FragmentsTime FactorsTroponin TVentricular Dysfunction, LeftBiomarkersNatriuretic Peptide, BrainPeptide Fragmentspro-brain natriuretic peptide (1-76)Troponin Tanthracyclinesbreast cancercardiotoxicitychemotherapytrastuzumab

Identifiers

PMID31042319
PMCPMC6722325

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.