Author + information
- Jennifer Meloche,
- Mark Nolan,
- Eitan Amir,
- Christine Brezden-Masley,
- Andrew Yan,
- Babitha Thampinathan,
- Anna Woo,
- Wintersperger Bernd and
- Paaladinesh Thavendiranathan
Changes to left atrial function (LAF) during cancer therapy have not been described. We sought to study the impact of cancer therapy on LAF in women with breast cancer (BC).
51 women (50.5±9.8 years) with HER2+ BC treated with sequential anthracycline (epirubicin 300mg/m2) and trastuzumab were prospectively recruited. All had structurally normal hearts and no history of atrial fibrillation. Using high frame rate apical 4 and 2 chamber views, LAF was measured with 2D speckle tracking echocardiography (Siemens VVI) pretreatment (T0), post anthracycline (T1), and at 3-month intervals during trastuzumab (T2-T5) by a single reader blinded to clinical data. Mixed linear models were used to evaluate changes.
LAF was reduced in all treatment phases (Figure). Conduit strain fell at T1 (29.5±7.6% to 27±8.5, p=0.008), while reservoir (49.7± 8.8% to 44.4±10.4%, p<0.001) and contractile strain (20.2±4.6% to 17.3±5.3%, p<0.001) fell at T2. Nine patients met CREC cardiotoxicity criteria (CTX). These patients had lower baseline reservoir (50.0±9.6% vs 45.6±4.9%, p=0.058) and conduit strain (30.1±8.0% vs 24.3±4.6%, p=0.008). CTX occurred at T2 or T3 in 7 patients with an increase in contractile strain (Figure).
Intrinsic LA compliance and contractile properties were reduced early with cancer therapy. Patients who developed CTX had lower baseline reservoir and conduit LAF. At time of CTX, contractile LAF increased, possibly compensating for a reduction in LV contractility.
Poster Hall, Hall A/B
Saturday, March 10, 2018, 10:00 a.m.-10:45 a.m.
Session Title: Echocardiography in Evaluating Heart Failure
Abstract Category: 28. Non Invasive Imaging: Echo
Presentation Number: 1122-347
- 2018 American College of Cardiology Foundation