Left atrial volume in patients with HER2‐positive breast cancer: One step further to predict trastuzumab‐related cardiotoxicity

Bergamini, Corinna; Dolci, Giulia; Rossi, Andrea; Torelli, F.; Ghiselli, Luca; Trevisani, Laura; Vinco, Giulia; Truong, S.; Russa, Francesca La; Golia, Giorgio; Molino, Annamaria; Benfari, Giovanni; Ribichini, Flavio

doi:10.1002/clc.22872

Cited by 15 publications

(24 citation statements)

References 24 publications

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“… 13 In breast cancer patients receiving chemotherapy, LA dilatation has been proven to be related to the occurrence of cardiac dysfunction. 14 However, in a study conducted among long‐term survivors of childhood cancer treated with anthracyclines, the LAVI of the chemotherapy group decreased notably compared with that of the control group. However, LAEF did not change significantly.…”

Section: Discussionmentioning

confidence: 98%

Evaluation of left atrial function and mechanical dispersion in breast cancer patients after chemotherapy

Chen

Liu

Sun

et al. 2022

Clinical Cardiology

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Background Left atrial (LA) function and mechanical dispersion changes in breast cancer patients treated with chemotherapy remain unclear. Hypothesis LA function and LA mechanical dispersion in breast cancer patients would be impaired after chemotherapy. Methods This single‐center retrospective study included 91 consecutive breast cancer patients treated with chemotherapy and 30 controls. Patients were examined by echocardiography three times at intervals. Conventional parameters, left ventricular strain, LA strain, and LA mechanical dispersion were evaluated and compared. Results LA strain during reservoir phase (LASr), conduit phase (LAScd), and contraction phase (LASct) all decreased markedly after chemotherapy and were lower than those of the controls (all p < .01). The standard deviation of time to peak positive strain during LA reservoir phase corrected by R‐R interval (LA SD‐TPSr) was significantly increased after chemotherapy and was higher than that of the controls ( p < .001). The change of LA function was expressed as Δ. Multivariate linear regression analyses showed that LAVIp (0.399, 95% confidence interval [CI]: 0.610, 1.756, p = .000) was independently associated with ΔLASr, LAPEF (−0.325, 95% CI: −45.123, −10.676, p = .002) and age (0.227, 95% CI: 0.021, 0.350, p = .027) were independently associated with ΔLAScd, and LAVImax (0.341, 95% CI: 0.192, 0.723, p = .001) was independently associated with ΔLASct. LAVImax (0.505, 95% CI: 0.000, 0.001, p = .039) and mitral E (−0.256, 95% CI: 0.000, 0.000, p = .024）were independently associated with ΔLA SD‐TPSr. Conclusions Mechanical function of LA declined after chemotherapy in breast cancer patients. With the decrease of LA mechanical function, LA mechanical dispersion assessed by two‐dimensional speckle‐tracking echocardiography increased significantly, and its clinical value needs to be further studied.

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Section: Discussionmentioning

confidence: 98%

Evaluation of left atrial function and mechanical dispersion in breast cancer patients after chemotherapy

Chen

Liu

Sun

et al. 2022

Clinical Cardiology

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Section: Introductionmentioning

confidence: 99%

“…Recently published studies showed significant dilatation and reduction in LA contractile function in patients after chemotherapy [6,7,8]. The authors claimed that LA dilatation during chemotherapy predicted cardiotoxicity development in HER2-positive breast cancer patients [8]. A recent investigation showed that it was not baseline LAV that indexed for BSA (LAVI), but that increment of LAVI during trastuzumab was associated with cardiotoxicity [9].…”

Section: Introductionmentioning

confidence: 99%

Phasic Left Atrial Function in Cancer Patients Before Initiation of Anti-Cancer Therapy

Tadić

Genger

Cuspidi

et al. 2019

JCM

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: We aimed to explore left atrial (LA) remodeling in the patients with solid cancer before initiation of chemo- or radiotherapy. This retrospective investigation included 92 chemo- and radiotherapy-naive cancer patients and 40 age- and gender-matched controls with a similar cardiovascular risk profile as the cancer group. All participants underwent comprehensive echocardiographic examination before the start of chemo- or radiotherapy. LA phasic function was evaluated in volumetric and strain method. Indexed minimal and pre-A LA volumes were significantly higher in the cancer patients. Total and passive LA emptying fraction (EF) were significantly lower, whereas active LAEF was significantly higher in the cancer patients. LA total longitudinal strain was significantly lower in the cancer patients. Strain rate analysis of LA phasic function showed that LA function during systole and early diastole was reduced in the cancer group, while it was increased during late diastole. These findings indicated that LA reservoir and conduit functions, assessed with LA volumetric and strain analysis, were deteriorated in the cancer group. On the other hand, LA booster pump function was elevated in the cancer group in comparison with the controls. In the whole population, cancer was associated with reduced LA total longitudinal strain independently of age, gender, BMI, LV hypertrophy, E/e’ ratio, diabetes, and hypertension. LA phasic function was impaired in the chemo- and radiotherapy-naive cancer patients in comparison with the control group. Cancer, LV hypertrophy, and hypertension were associated with reduced LA longitudinal strain independently of other important clinical parameters.

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“…LA enlargement and dysfunction may relate with higher risk of cardiotoxicity during therapy in breast cancer [ 33 , 34 ]. Furthermore, a retrospective study including 92 therapy-naive cancer patients and their matched controls suggests that LA reservoir and functions are deteriorated in the cancer group [ 35 ].…”

Section: Atrial Cardiomyopathy In Cancermentioning

confidence: 99%

Atrial Cardiomyopathy and Atrial Fibrillation in Cancer

Ren

Yao

Yue

et al. 2021

Cardiology Research and Practice

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The number of patients with oncologic and cardiologic comorbidities is increasing. A growing number of evidence shows an inextricable link between cancer, atrial fibrillation, and atrial cardiomyopathy. Cancer itself and resultant inflammation, anticancer treatment, and other comorbidities lead to atrial remodeling and fibrosis, which increases the tendency to develop atrial cardiomyopathy and atrial fibrillation. The scarcity of current literature and ambiguous results make its relationship difficult to fully understand. In this review, we will summarize existing evidence of the relationships and interactions among cancer, atrial cardiomyopathy, and atrial fibrillation and discuss the underlying mechanisms, and provide better information for the management of these patients.

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Left atrial volume in patients with HER2‐positive breast cancer: One step further to predict trastuzumab‐related cardiotoxicity

Cited by 15 publications

References 24 publications

Evaluation of left atrial function and mechanical dispersion in breast cancer patients after chemotherapy

Evaluation of left atrial function and mechanical dispersion in breast cancer patients after chemotherapy

Phasic Left Atrial Function in Cancer Patients Before Initiation of Anti-Cancer Therapy

Atrial Cardiomyopathy and Atrial Fibrillation in Cancer

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