ArticleESC heart failure2025
Decoding anthracycline- and trastuzumab-related cardiac dysfunction prediction: HFA-ICOS scores versus strain imaging.
Article in ESC heart failure, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed.
- Heart failure induced by cancer therapies: focus on targeted agents, mechanisms, risk prediction, and clinical management.Frontiers in pharmacology · 2026Review
- Risk factors for trastuzumab-induced cardiotoxicity in HER2-positive breast cancer patients.Frontiers in oncology · 2026Article
- Decoding anthracycline- and trastuzumab-related cardiac dysfunction prediction: HFA-ICOS scores versus strain imaging.ESC heart failure · 2025Article
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5 authors.
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Abstract
aimsBaseline Heart Failure Association-International Cardio-Oncology Society (HFA-ICOS) scores and serial left ventricular global longitudinal strain (LV-GLS) measurements have been found to be useful in predicting cancer therapy-related cardiac dysfunction (CTRCD). However, their integration for the purpose of improving prognostic accuracy remains unclear; and we aimed to develop a predictive model for CTRCD using baseline HFA-ICOS scores and the relative decline of LV-GLS in patients on anthracycline or trastuzumab.
methodsWe prospectively enrolled 443 chemotherapy-naïve women with breast cancer and cardiovascular risk factors, scheduled to receive anthracycline (n = 333) or trastuzumab (n = 110). Participants were stratified by the HFA-ICOS risk score. The left ventricular ejection fraction (LVEF) and LV-GLS were evaluated using echocardiography at baseline, before each treatment cycle, and every 3 months in the first year post-chemotherapy. CTRCD was a new LVEF reduction ≥10 percentage points to an LVEF < 50%, irrespective of symptoms.
resultsIn terms of HFA-ICOS stratification, 258 patients (58.2%) were low risk, 180 (40.6%) were moderate risk and 5 (1.2%) were high risk. The proportions of low- and moderate-risk patients were similar in the anthracycline and trastuzumab groups. Twenty-four (7.2%) and seven (6.4%) patients treated with anthracycline and trastuzumab, respectively, displayed asymptomatic CTRCD. The addition of the baseline HFA-ICOS risk score did not improve the performance of the significant relative decline of LV-GLS > 15% in predicting both anthracycline [area under the receiver-operating characteristic curve (AUC) 0.93, 95% confidence interval (CI) 0.89-0.96, sensitivity 87.5%, specificity 93.2%] and trastuzumab (AUC 0.97, 95% CI 0.88-0.99, sensitivity 85.7%, specificity 93.2%)-related cardiac dysfunction.
conclusionsContemporary anthracycline and trastuzumab-based regimens resulted in similarly low incidences of CTRCD. In this context, LV-GLS evolution was the best predictor of CTRCD.
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