Contrast Echocardiography and vector velocity imaging in the early detection and monitoring of anthracycline and trastuzumab-induced cardiotoxicity in patients with breast cancer

Abstract

Background:Per the GLOBOCAN 2018 data, breast cancer constitutes 19.2% of female cancer cases in China. Objective: The study aimed to detect and monitor the early cardiotoxicity of the sequential regimen of anthracycline and trastuzumab in patients with HER-2 positive breast cancer, using VVI technology combined with contrast echocardiography. Methods: This prospective study enrolled patients who underwent surgery for breast cancer at the Jiading District Central Hospital affiliated to Shanghai University of Medicine & Health Sciences, Shanghai, China. All included patients underwent routine echocardiography, VVI, and contrast echocardiography examinations at three time points: the baseline (T0), after 4 cycles of anthracycline chemotherapy (T1), and after 17 cycles of trastuzumab(T2). Results: A total of 44 patients were included in this study. Compared to the time point T0, the global longitudinal strain of the left ventricle at time intervals T1 and T2 were lower than that of before, with a statistically significant difference (P<0.05). Myocardial perfusion delay were observed in T1 and T2, compared with T0, the difference was statistically significant (P<0.05). The occurrence rates of abnormal T wave on electrocardiography at T1 and T2 time points were significantly higher than that at T0 time interval, and the differences were statistically significant (P<0.05). Conclusion: VVI technology combined with contrast echocardiography could evaluate the changes of left ventricular systolic function and myocardial perfusion microcirculation after sequential administration of anthracycline and trastuzumab treatment. This modality may be helpful for the early detection of chemotherapy-related subclinical cardiotoxicity.