Cardiac Energetics Before, During, and After Anthracycline-Based Chemotherapy in Breast Cancer Patients Using 31P Magnetic Resonance Spectroscopy: A Pilot Study
Purpose: To explore the utility of phosphorus magnetic resonance spectroscopy (31P MRS) in identifying anthracycline-induced cardiac toxicity in patients with breast cancer.Methods: Twenty patients with newly diagnosed breast cancer receiving anthracycline-based chemotherapy had cardiac magnetic res...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-04-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2021.653648/full |
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| author | Gillian Macnaught Gillian Macnaught Olga Oikonomidou Olga Oikonomidou Christopher T. Rodgers William Clarke Annette Cooper Heather McVicars Heather McVicars Larry Hayward Larry Hayward Saeed Mirsadraee Scott Semple Scott Semple Martin A. Denvir |
| author_facet | Gillian Macnaught Gillian Macnaught Olga Oikonomidou Olga Oikonomidou Christopher T. Rodgers William Clarke Annette Cooper Heather McVicars Heather McVicars Larry Hayward Larry Hayward Saeed Mirsadraee Scott Semple Scott Semple Martin A. Denvir |
| author_sort | Gillian Macnaught |
| collection | DOAJ |
| description | Purpose: To explore the utility of phosphorus magnetic resonance spectroscopy (31P MRS) in identifying anthracycline-induced cardiac toxicity in patients with breast cancer.Methods: Twenty patients with newly diagnosed breast cancer receiving anthracycline-based chemotherapy had cardiac magnetic resonance assessment of left ventricular ejection fraction (LVEF) and 31P MRS to determine myocardial Phosphocreatine/Adenosine Triphosphate Ratio (PCr/ATP) at three time points: pre-, mid-, and end-chemotherapy. Plasma high sensitivity cardiac troponin-I (cTn-I) tests and electrocardiograms were also performed at these same time points.Results: Phosphocreatine/Adenosine Triphosphate did not change significantly between pre- and mid-chemo (2.16 ± 0.46 vs. 2.00 ± 0.56, p = 0.80) and pre- and end-chemo (2.16 ± 0.46 vs. 2.17 ± 0.86, p = 0.99). Mean LVEF reduced significantly by 5.1% between pre- and end-chemo (61.4 ± 4.4 vs. 56.3 ± 8.1 %, p = 0.02). Change in PCr/ATP ratios from pre- to end-chemo correlated inversely with changes in LVEF over the same period (r = −0.65, p = 0.006). Plasma cTn-I increased progressively during chemotherapy from pre- to mid-chemo (1.35 ± 0.81 to 4.40 ± 2.64 ng/L; p = 0.01) and from mid- to end-chemo (4.40 ± 2.64 to 18.33 ± 13.23 ng/L; p = 0.001).Conclusions: In this small cohort pilot study, we did not observe a clear change in mean PCr/ATP values during chemotherapy despite evidence of increased plasma cardiac biomarkers and reduced LVEF. Future similar studies should be adequately powered to take account of patient drop-out and variable changes in PCr/ATP and could include T1 and T2 mapping. |
| first_indexed | 2024-12-14T01:48:21Z |
| format | Article |
| id | doaj.art-294f7bfcdaa846c6a51b46ee9a0236e9 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-12-14T01:48:21Z |
| publishDate | 2021-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-294f7bfcdaa846c6a51b46ee9a0236e92022-12-21T23:21:27ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2021-04-01810.3389/fcvm.2021.653648653648Cardiac Energetics Before, During, and After Anthracycline-Based Chemotherapy in Breast Cancer Patients Using 31P Magnetic Resonance Spectroscopy: A Pilot StudyGillian Macnaught0Gillian Macnaught1Olga Oikonomidou2Olga Oikonomidou3Christopher T. Rodgers4William Clarke5Annette Cooper6Heather McVicars7Heather McVicars8Larry Hayward9Larry Hayward10Saeed Mirsadraee11Scott Semple12Scott Semple13Martin A. Denvir14Edinburgh Imaging Facility, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United KingdomCentre for Cardiovascular Sciences, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United KingdomEdinburgh Cancer Research Centre, University of Edinburgh, Edinburgh, United KingdomEdinburgh Cancer Centre, Western General Hospital, Edinburgh, United KingdomDepartment of Clinical Neurosciences, Wolfson Brain Imaging Centre, University of Cambridge, Cambridge, United KingdomDivision of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Level 0, John Radcliffe Hospital, Oxford, United KingdomEdinburgh Imaging Facility, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United KingdomEdinburgh Cancer Research Centre, University of Edinburgh, Edinburgh, United KingdomEdinburgh Cancer Centre, Western General Hospital, Edinburgh, United KingdomEdinburgh Cancer Research Centre, University of Edinburgh, Edinburgh, United KingdomEdinburgh Cancer Centre, Western General Hospital, Edinburgh, United KingdomDepartment of Cardiology, Royal Brompton Hospital, London, United KingdomEdinburgh Imaging Facility, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United KingdomCentre for Cardiovascular Sciences, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United KingdomCentre for Cardiovascular Sciences, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United KingdomPurpose: To explore the utility of phosphorus magnetic resonance spectroscopy (31P MRS) in identifying anthracycline-induced cardiac toxicity in patients with breast cancer.Methods: Twenty patients with newly diagnosed breast cancer receiving anthracycline-based chemotherapy had cardiac magnetic resonance assessment of left ventricular ejection fraction (LVEF) and 31P MRS to determine myocardial Phosphocreatine/Adenosine Triphosphate Ratio (PCr/ATP) at three time points: pre-, mid-, and end-chemotherapy. Plasma high sensitivity cardiac troponin-I (cTn-I) tests and electrocardiograms were also performed at these same time points.Results: Phosphocreatine/Adenosine Triphosphate did not change significantly between pre- and mid-chemo (2.16 ± 0.46 vs. 2.00 ± 0.56, p = 0.80) and pre- and end-chemo (2.16 ± 0.46 vs. 2.17 ± 0.86, p = 0.99). Mean LVEF reduced significantly by 5.1% between pre- and end-chemo (61.4 ± 4.4 vs. 56.3 ± 8.1 %, p = 0.02). Change in PCr/ATP ratios from pre- to end-chemo correlated inversely with changes in LVEF over the same period (r = −0.65, p = 0.006). Plasma cTn-I increased progressively during chemotherapy from pre- to mid-chemo (1.35 ± 0.81 to 4.40 ± 2.64 ng/L; p = 0.01) and from mid- to end-chemo (4.40 ± 2.64 to 18.33 ± 13.23 ng/L; p = 0.001).Conclusions: In this small cohort pilot study, we did not observe a clear change in mean PCr/ATP values during chemotherapy despite evidence of increased plasma cardiac biomarkers and reduced LVEF. Future similar studies should be adequately powered to take account of patient drop-out and variable changes in PCr/ATP and could include T1 and T2 mapping.https://www.frontiersin.org/articles/10.3389/fcvm.2021.653648/fullchemotherapybreast cancercardiac energeticstroponinejection fraction |
| spellingShingle | Gillian Macnaught Gillian Macnaught Olga Oikonomidou Olga Oikonomidou Christopher T. Rodgers William Clarke Annette Cooper Heather McVicars Heather McVicars Larry Hayward Larry Hayward Saeed Mirsadraee Scott Semple Scott Semple Martin A. Denvir Cardiac Energetics Before, During, and After Anthracycline-Based Chemotherapy in Breast Cancer Patients Using 31P Magnetic Resonance Spectroscopy: A Pilot Study Frontiers in Cardiovascular Medicine chemotherapy breast cancer cardiac energetics troponin ejection fraction |
| title | Cardiac Energetics Before, During, and After Anthracycline-Based Chemotherapy in Breast Cancer Patients Using 31P Magnetic Resonance Spectroscopy: A Pilot Study |
| title_full | Cardiac Energetics Before, During, and After Anthracycline-Based Chemotherapy in Breast Cancer Patients Using 31P Magnetic Resonance Spectroscopy: A Pilot Study |
| title_fullStr | Cardiac Energetics Before, During, and After Anthracycline-Based Chemotherapy in Breast Cancer Patients Using 31P Magnetic Resonance Spectroscopy: A Pilot Study |
| title_full_unstemmed | Cardiac Energetics Before, During, and After Anthracycline-Based Chemotherapy in Breast Cancer Patients Using 31P Magnetic Resonance Spectroscopy: A Pilot Study |
| title_short | Cardiac Energetics Before, During, and After Anthracycline-Based Chemotherapy in Breast Cancer Patients Using 31P Magnetic Resonance Spectroscopy: A Pilot Study |
| title_sort | cardiac energetics before during and after anthracycline based chemotherapy in breast cancer patients using 31p magnetic resonance spectroscopy a pilot study |
| topic | chemotherapy breast cancer cardiac energetics troponin ejection fraction |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2021.653648/full |
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