Prognostic Impact of Global Longitudinal Strain and NT-proBNP on Early Development of Cardiotoxicity in Breast Cancer Patients Treated with Anthracycline-Based Chemotherapy
<i>Background</i>. The most important anthracycline side effect is cardiotoxicity, resulting in congestive heart failure (HF). Early detection of cardiac dysfunction and appropriate treatment can improve outcomes and reduce the progression of HF. The aim of our study was to evaluate chan...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-05-01
|
| Series: | Medicina |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1648-9144/59/5/953 |
| _version_ | 1797599129396838400 |
|---|---|
| author | Gintare Muckiene Domas Vaitiekus Diana Zaliaduonyte Vytautas Zabiela Raimonda Verseckaite-Costa Dovile Vaiciuliene Elona Juozaityte Renaldas Jurkevicius |
| author_facet | Gintare Muckiene Domas Vaitiekus Diana Zaliaduonyte Vytautas Zabiela Raimonda Verseckaite-Costa Dovile Vaiciuliene Elona Juozaityte Renaldas Jurkevicius |
| author_sort | Gintare Muckiene |
| collection | DOAJ |
| description | <i>Background</i>. The most important anthracycline side effect is cardiotoxicity, resulting in congestive heart failure (HF). Early detection of cardiac dysfunction and appropriate treatment can improve outcomes and reduce the progression of HF. The aim of our study was to evaluate changes in clinical data, echocardiographic parameters, and NT-proBNP, as well as their associations with early anthracycline-induced cardiotoxicity (AIC) in patients treated with anthracycline-based chemotherapy. <i>Methods and Materials</i>. Patients with breast cancer were prospectively assessed with echocardiography, as well as NT-proBNP testing at baseline, (T0), after two cycles (T1) and four cycles (T2) of chemotherapy. AIC was defined as a new decrease in the LVEF of 10 percentage points, to a value below the lower limit of normal. <i>Results.</i> We evaluated 85 patients aged 54.5 ± 9.3 years. After a cumulative dose of 237.9 mg/m<sup>2</sup> of doxorubicin, 22 patients (25.9%) met the criteria of AIC after chemotherapy. Patients who subsequently progressed to cardiotoxicity had demonstrated a significantly larger impairment in LV systolic function compared to those who did not develop cardiotoxicity (LVEF: 54.0 ± 1.6% vs. 57.1 ± 1.4% at T1, <i>p</i> < 0.001, and 49.9 ± 2.1% vs. 55.8 ± 1.6% at T2, <i>p</i> < 0.001; GLS: −17.8 ± 0.4% vs. −19.3 ± 0.9% at T1, <i>p</i> < 0.001, and −16.5 ± 11.1% vs. −18.5 ± 0.9% at T2, <i>p</i> < 0.001, respectively). The levels of NT-proBNP increased significantly from 94.8 ± 43.8 ng/L to 154.1 ± 75.6 ng/L, <i>p</i> < 0.001. A relative decrease in GLS ≤ −18.0% (sensitivity: 72.73%; specificity: 92.06%; AUC, 0.94; <i>p</i> < 0.001) and a relative increase in NT-proBNP > 125 ng/L (sensitivity: 90.0%; specificity: 56.9%; AUC, 0.78; <i>p</i> < 0.001) from baseline to T1 predicted subsequent LV cardiotoxicity at T2. <i>Conclusions</i>. Decrease in GLS and elevation in NT-proBNP were significantly associated with AIC, and these could potentially be used to predict subsequent declines in LVEF with anthracycline-based chemotherapy. |
| first_indexed | 2024-03-11T03:31:17Z |
| format | Article |
| id | doaj.art-663b780a4617474ba9d472bd396c5762 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-11T03:31:17Z |
| publishDate | 2023-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-663b780a4617474ba9d472bd396c57622023-11-18T02:22:48ZengMDPI AGMedicina1010-660X1648-91442023-05-0159595310.3390/medicina59050953Prognostic Impact of Global Longitudinal Strain and NT-proBNP on Early Development of Cardiotoxicity in Breast Cancer Patients Treated with Anthracycline-Based ChemotherapyGintare Muckiene0Domas Vaitiekus1Diana Zaliaduonyte2Vytautas Zabiela3Raimonda Verseckaite-Costa4Dovile Vaiciuliene5Elona Juozaityte6Renaldas Jurkevicius7Cardiology Clinic, Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, LithuaniaDepartment of Oncology and Hematology, Hospital of Lithuanian University of Health Sciences, 50161 Kaunas, LithuaniaCardiology Clinic, Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, LithuaniaCardiology Clinic, Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, LithuaniaDepartment of Cardiology, Hospital of Lithuanian University of Health Sciences, 50161 Kaunas, LithuaniaDepartment of Cardiology, Hospital of Lithuanian University of Health Sciences, 50161 Kaunas, LithuaniaInstitute of Oncology, Lithuanian University of Health Sciences, 50161 Kaunas, LithuaniaCardiology Clinic, Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania<i>Background</i>. The most important anthracycline side effect is cardiotoxicity, resulting in congestive heart failure (HF). Early detection of cardiac dysfunction and appropriate treatment can improve outcomes and reduce the progression of HF. The aim of our study was to evaluate changes in clinical data, echocardiographic parameters, and NT-proBNP, as well as their associations with early anthracycline-induced cardiotoxicity (AIC) in patients treated with anthracycline-based chemotherapy. <i>Methods and Materials</i>. Patients with breast cancer were prospectively assessed with echocardiography, as well as NT-proBNP testing at baseline, (T0), after two cycles (T1) and four cycles (T2) of chemotherapy. AIC was defined as a new decrease in the LVEF of 10 percentage points, to a value below the lower limit of normal. <i>Results.</i> We evaluated 85 patients aged 54.5 ± 9.3 years. After a cumulative dose of 237.9 mg/m<sup>2</sup> of doxorubicin, 22 patients (25.9%) met the criteria of AIC after chemotherapy. Patients who subsequently progressed to cardiotoxicity had demonstrated a significantly larger impairment in LV systolic function compared to those who did not develop cardiotoxicity (LVEF: 54.0 ± 1.6% vs. 57.1 ± 1.4% at T1, <i>p</i> < 0.001, and 49.9 ± 2.1% vs. 55.8 ± 1.6% at T2, <i>p</i> < 0.001; GLS: −17.8 ± 0.4% vs. −19.3 ± 0.9% at T1, <i>p</i> < 0.001, and −16.5 ± 11.1% vs. −18.5 ± 0.9% at T2, <i>p</i> < 0.001, respectively). The levels of NT-proBNP increased significantly from 94.8 ± 43.8 ng/L to 154.1 ± 75.6 ng/L, <i>p</i> < 0.001. A relative decrease in GLS ≤ −18.0% (sensitivity: 72.73%; specificity: 92.06%; AUC, 0.94; <i>p</i> < 0.001) and a relative increase in NT-proBNP > 125 ng/L (sensitivity: 90.0%; specificity: 56.9%; AUC, 0.78; <i>p</i> < 0.001) from baseline to T1 predicted subsequent LV cardiotoxicity at T2. <i>Conclusions</i>. Decrease in GLS and elevation in NT-proBNP were significantly associated with AIC, and these could potentially be used to predict subsequent declines in LVEF with anthracycline-based chemotherapy.https://www.mdpi.com/1648-9144/59/5/953anthracyclinedoxorubicinbreast cancercardiotoxicityglobal longitudinal strainNT-proBNP |
| spellingShingle | Gintare Muckiene Domas Vaitiekus Diana Zaliaduonyte Vytautas Zabiela Raimonda Verseckaite-Costa Dovile Vaiciuliene Elona Juozaityte Renaldas Jurkevicius Prognostic Impact of Global Longitudinal Strain and NT-proBNP on Early Development of Cardiotoxicity in Breast Cancer Patients Treated with Anthracycline-Based Chemotherapy Medicina anthracycline doxorubicin breast cancer cardiotoxicity global longitudinal strain NT-proBNP |
| title | Prognostic Impact of Global Longitudinal Strain and NT-proBNP on Early Development of Cardiotoxicity in Breast Cancer Patients Treated with Anthracycline-Based Chemotherapy |
| title_full | Prognostic Impact of Global Longitudinal Strain and NT-proBNP on Early Development of Cardiotoxicity in Breast Cancer Patients Treated with Anthracycline-Based Chemotherapy |
| title_fullStr | Prognostic Impact of Global Longitudinal Strain and NT-proBNP on Early Development of Cardiotoxicity in Breast Cancer Patients Treated with Anthracycline-Based Chemotherapy |
| title_full_unstemmed | Prognostic Impact of Global Longitudinal Strain and NT-proBNP on Early Development of Cardiotoxicity in Breast Cancer Patients Treated with Anthracycline-Based Chemotherapy |
| title_short | Prognostic Impact of Global Longitudinal Strain and NT-proBNP on Early Development of Cardiotoxicity in Breast Cancer Patients Treated with Anthracycline-Based Chemotherapy |
| title_sort | prognostic impact of global longitudinal strain and nt probnp on early development of cardiotoxicity in breast cancer patients treated with anthracycline based chemotherapy |
| topic | anthracycline doxorubicin breast cancer cardiotoxicity global longitudinal strain NT-proBNP |
| url | https://www.mdpi.com/1648-9144/59/5/953 |
| work_keys_str_mv | AT gintaremuckiene prognosticimpactofgloballongitudinalstrainandntprobnponearlydevelopmentofcardiotoxicityinbreastcancerpatientstreatedwithanthracyclinebasedchemotherapy AT domasvaitiekus prognosticimpactofgloballongitudinalstrainandntprobnponearlydevelopmentofcardiotoxicityinbreastcancerpatientstreatedwithanthracyclinebasedchemotherapy AT dianazaliaduonyte prognosticimpactofgloballongitudinalstrainandntprobnponearlydevelopmentofcardiotoxicityinbreastcancerpatientstreatedwithanthracyclinebasedchemotherapy AT vytautaszabiela prognosticimpactofgloballongitudinalstrainandntprobnponearlydevelopmentofcardiotoxicityinbreastcancerpatientstreatedwithanthracyclinebasedchemotherapy AT raimondaverseckaitecosta prognosticimpactofgloballongitudinalstrainandntprobnponearlydevelopmentofcardiotoxicityinbreastcancerpatientstreatedwithanthracyclinebasedchemotherapy AT dovilevaiciuliene prognosticimpactofgloballongitudinalstrainandntprobnponearlydevelopmentofcardiotoxicityinbreastcancerpatientstreatedwithanthracyclinebasedchemotherapy AT elonajuozaityte prognosticimpactofgloballongitudinalstrainandntprobnponearlydevelopmentofcardiotoxicityinbreastcancerpatientstreatedwithanthracyclinebasedchemotherapy AT renaldasjurkevicius prognosticimpactofgloballongitudinalstrainandntprobnponearlydevelopmentofcardiotoxicityinbreastcancerpatientstreatedwithanthracyclinebasedchemotherapy |