Author + information
- Jennifer H. Jordan,
- Giselle Melendez,
- Cynthia Suerken,
- Ralph D'Agostino and
- W. Hundley
Background: Cancer therapy related cardiovascular dysfunction (CTRCD) is a known consequence of modern cancer therapies and is identified through changes in left ventricular ejection fraction (LVEF) and strain by echocardiography or cardiovascular magnetic resonance (CMR) imaging. LV remodeling and impaired ventricular-vascular coupling also occur. It is unknown, however, how these measures associate with heart failure (HF) assessed by questionnaire in patients at risk for CTRCD.
Methods: Serial CMR examinations were performed in 86 participants (24 cancer-free comparators and 62 cancer patients treated with CTRCD associated chemotherapy) to blindly assess LV mass, LVEF, LV wall stress index, arterial elastance, and aortic distensibility at baseline (pre-treatment) and six months thereafter. The Minnesota Living with Heart Failure Questionnaire (MLHFQ) was administered in cancer patients at each visit. Serial changes were assessed using paired t tests and associations were determined with Pearson's correlation coefficients.
Results: Six months after initiating chemotherapy, cancer patients experienced subclinical changes in LV mass, LVEF, wall stress index, total MLHFQ score, and MLHFQ-HF symptoms score (p<0.02 for all). No changes were observed in comparators. A change in total MLHFQ score trended to be associated with LV mass (p=0.10) but not LVEF declines (p=0.40). Similarly, MLHFQ-HF symptoms score was associated with declines in LV mass (p=0.04) rather than LVEF (p=0.73). Arterial elastance and aortic distensibility were elevated compared to published normative data but did not change significantly and were not associated with MLHFQ scores.
Conclusions: Six months after initiating potentially cardiotoxic chemotherapy, increases in MLHFQ were associated with LV mass declines but not LVEF decrements. These data suggest that a decline in LV mass in the setting of increased wall and vascular stiffness are unexpected in normal forms of remodeling and may demonstrate multiple manifestations of CTRCD mechanisms. Further studies are needed to determine if LV mass declines in the setting of increased stiffness contribute to the development of HF after chemotherapy receipt.
Moderated Poster Contributions
Non Invasive Imaging Moderated Poster Theater, Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-9:55 a.m.
Session Title: Advances in Imaging to Assess Cardiotoxicity
Abstract Category: 29. Non Invasive Imaging: MR
Presentation Number: 1215M-03
- 2017 American College of Cardiology Foundation