Subclinical left ventricular dysfunction detected by speckle-tracking echocardiography in breast cancer patients treated with radiation therapy: a six-month follow-up analysis (MEDIRAD EARLY-HEART study)

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  • dc.contributor.author Locquet, Médéa
  • dc.contributor.author Spoor, Daan
  • dc.contributor.author Crijns, Anne
  • dc.contributor.author van der Harst, Pim
  • dc.contributor.author Eraso, Arantxa
  • dc.contributor.author Guedea, Ferrán
  • dc.contributor.author Fiuza, Manuela
  • dc.contributor.author Santos, Susana Constantino Rosa
  • dc.contributor.author Combs, Stephanie
  • dc.contributor.author Borm, Kai
  • dc.contributor.author Mousseaux, Elie
  • dc.contributor.author Gencer, Umit
  • dc.contributor.author Frija, Guy
  • dc.contributor.author Cardis, Elisabeth
  • dc.contributor.author Langendijk, Hans
  • dc.contributor.author Jacob, Sophie
  • dc.date.accessioned 2022-12-02T07:11:27Z
  • dc.date.available 2022-12-02T07:11:27Z
  • dc.date.issued 2022
  • dc.description.abstract Background: In the case of breast cancer (BC), radiotherapy (RT) helps reduce locoregional recurrence and BC-related deaths but can lead to cardiotoxicity, resulting in an increased risk of long-term major cardiovascular events. It is therefore of primary importance to early detect subclinical left ventricular (LV) dysfunction in BC patients after RT and to determine the dose-response relationships between cardiac doses and these events. Methods: Within the frame of the MEDIRAD European project (2017-2022), the prospective multicenter EARLY-HEART study (ClinicalTrials.gov Identifier: NCT03297346) included chemotherapy naïve BC women aged 40-75 years and treated with lumpectomy and adjuvant RT. Myocardial strain analysis was provided using speckle-tracking echocardiography performed at baseline and 6 months following RT. A global longitudinal strain (GLS) reduction >15% between baseline and follow-up was defined as a GLS-based subclinical LV dysfunction. Individual patient dose distributions were obtained using multi-atlas-based auto-segmentation of the heart. Dose-volume parameters were studied for the whole heart (WH) and left ventricle (LV). Results: The sample included 186 BC women (57.5 ± 7.9 years, 64% left-sided BC). GLS-based subclinical LV dysfunction was observed in 22 patients (14.4%). These patients had significantly higher cardiac exposure regarding WH and LV doses compared to patients without LV dysfunction (for mean WH dose: 2.66 ± 1.75 Gy versus 1.64 ± 0.96 Gy, p = 0.01). A significantly increased risk of subclinical LV dysfunction was observed with the increase in the dose received to the WH [ORs from 1.13 (V5) to 1.74 (Dmean); p <0.01] and to the LV [ORs from 1.10 (V5) to 1.46 (Dmean); p <0.01]. Based on ROC analysis, the LV-V5 parameter may be the best predictor of the short-term onset of subclinical LV dysfunction. Conclusion: These results highlighted that all cardiac doses were strongly associated with the occurrence of subclinical LV dysfunction arising 6 months after BC RT. Whether measurements of GLS at baseline and 6 months after RT combined with cardiac doses can early predict efficiently subclinical events occurring 24 months after RT remains to be investigated.
  • dc.description.sponsorship The European Community’s Horizon 2020 Programme supported the EARLY-HEART study conducted in the frame of the MEDIRAD - Implications of Medical Low Dose Radiation Exposure - project spanning from 2017 to 2021 granted by the Euratom Research and Training Programme 2014-2014 under agreement No. 755523.
  • dc.format.mimetype application/pdf
  • dc.identifier.citation Locquet M, Spoor D, Crijns A, van der Harst P, Eraso A, Guedea F, Fiuza M, Santos SCR, Combs S, Borm K, Mousseaux E, Gencer U, Frija G, Cardis E, Langendijk H, Jacob S. Subclinical left ventricular dysfunction detected by speckle-tracking echocardiography in breast cancer patients treated with radiation therapy: a six-month follow-up analysis (MEDIRAD EARLY-HEART study). Front Oncol. 2022 Jun 28;12:883679. DOI: 10.3389/fonc.2022.883679
  • dc.identifier.doi http://dx.doi.org/10.3389/fonc.2022.883679
  • dc.identifier.issn 2234-943X
  • dc.identifier.uri http://hdl.handle.net/10230/55073
  • dc.language.iso eng
  • dc.publisher Frontiers
  • dc.relation.ispartof Front Oncol. 2022 Jun 28;12:883679
  • dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/755523
  • dc.rights © 2022 Locquet, Spoor, Crijns, van der Harst, Eraso, Guedea, Fiuza, Santos, Combs, Borm, Mousseaux, Gencer, Frija, Cardis, Langendijk and Jacob. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
  • dc.rights.accessRights info:eu-repo/semantics/openAccess
  • dc.rights.uri http://creativecommons.org/licenses/by/4.0/
  • dc.subject.keyword EARLY-HEART cohort
  • dc.subject.keyword MEDIRAD
  • dc.subject.keyword Breast cancer
  • dc.subject.keyword Cardiac dysfunction
  • dc.subject.keyword Dosimetry
  • dc.subject.keyword Radiotherapy
  • dc.subject.keyword Strain imaging
  • dc.title Subclinical left ventricular dysfunction detected by speckle-tracking echocardiography in breast cancer patients treated with radiation therapy: a six-month follow-up analysis (MEDIRAD EARLY-HEART study)
  • dc.type info:eu-repo/semantics/article
  • dc.type.version info:eu-repo/semantics/publishedVersion

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Articles (Barcelona Institute for Global Health (ISGlobal) – Campus Mar)
Articles (Departament de Medicina i Ciències de la Vida)
Documents OpenAIRE (Open Access Infrastructure for Research in Europe)