Detection of Early Myocardial Dysfunction by Imaging Biomarkers in Cancer Patients Undergoing Photon Beam vs. Proton Beam Radiotherapy: A Prospective Study
<b>1. Background:</b> We sought to determine acute and subacute changes in cardiac function after proton beam (PBT) and photon beam (PhT) radiotherapy (RT) using conventional and two-dimensional speckle tracking echocardiography (2D-STE) in patients with malignant breast and thoracic tum...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-10-01
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| Series: | Journal of Cardiovascular Development and Disease |
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| Online Access: | https://www.mdpi.com/2308-3425/10/10/418 |
| _version_ | 1827720791486103552 |
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| author | Muhannad Aboud Abbasi Giulia Bruno Cristina Di Stefano Laura Garcia Bello Nadia N. Laack Kimberly S. Corbin Thomas J. Whitaker Patricia A. Pellikka Robert W. Mutter Hector R. Villarraga |
| author_facet | Muhannad Aboud Abbasi Giulia Bruno Cristina Di Stefano Laura Garcia Bello Nadia N. Laack Kimberly S. Corbin Thomas J. Whitaker Patricia A. Pellikka Robert W. Mutter Hector R. Villarraga |
| author_sort | Muhannad Aboud Abbasi |
| collection | DOAJ |
| description | <b>1. Background:</b> We sought to determine acute and subacute changes in cardiac function after proton beam (PBT) and photon beam (PhT) radiotherapy (RT) using conventional and two-dimensional speckle tracking echocardiography (2D-STE) in patients with malignant breast and thoracic tumors. <b>2. Methods:</b> Between March 2016 and March 2017, 70 patients with breast or thoracic cancer were prospectively enrolled and underwent transthoracic echocardiography with comprehensive strain analysis at pretreatment, mid-treatment, end of treatment, and 3 months after RT. <b>3. Results:</b> PBT was used to treat 44 patients; PhT 26 patients. Mean ± SD age was 55 ± 12 years; most patients (93%) were women. The median (interquartile range) of the mean heart dose was lower in the PBT than the PhT group (47 [27–79] vs. 217 [120–596] cGy, respectively; <i>p</i> < 0.001). Ejection fraction did not change in either group. Only the PhT group had reduced systolic tissue Doppler velocities at 3 months. 2D-STE showed changes in endocardial and epicardial longitudinal, radial, and circumferential early diastolic strain rate (SRe) in patients undergoing PhT (global longitudinal SRe, pretreatment vs. end of treatment (<i>p</i> = 0.04); global circumferential SRe, pretreatment vs. at 3-month follow-up (<i>p</i> = 0.003); global radial SRe, pretreatment vs. at 3-month follow-up (<i>p</i> = 0.02) for endocardial values). Epicardial strain values decreased significantly only in patients treated with PhT. Patients in the PhT group had a significant decrease in epicardial global longitudinal systolic strain rate (GLSRs) (epicardial GLSRs, at baseline vs. at end of treatment [<i>p</i> = 0.009]) and in GCSRe and GRSRe (epicardial GCSRe, at baseline vs. at 3-month follow-up (<i>p</i> = 0.02); epicardial GRSRe, at baseline vs. at 3-month follow-up (<i>p</i> = 0.03)) during treatment and follow-up. No changes on 2D-STE were detected in the PBT group. <b>4. Conclusions:</b> Patients who underwent PhT but not PBT had reduced tissue Doppler velocities and SRe values during follow-up, suggesting early myocardial relaxation abnormalities. PBT shows promise as a cardiac-sparing RT technology. |
| first_indexed | 2024-03-10T21:11:18Z |
| format | Article |
| id | doaj.art-f3e9b36b0e494faab4078ba87bbe65f2 |
| institution | Directory Open Access Journal |
| issn | 2308-3425 |
| language | English |
| last_indexed | 2024-03-10T21:11:18Z |
| publishDate | 2023-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Cardiovascular Development and Disease |
| spelling | doaj.art-f3e9b36b0e494faab4078ba87bbe65f22023-11-19T16:50:41ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252023-10-01101041810.3390/jcdd10100418Detection of Early Myocardial Dysfunction by Imaging Biomarkers in Cancer Patients Undergoing Photon Beam vs. Proton Beam Radiotherapy: A Prospective StudyMuhannad Aboud Abbasi0Giulia Bruno1Cristina Di Stefano2Laura Garcia Bello3Nadia N. Laack4Kimberly S. Corbin5Thomas J. Whitaker6Patricia A. Pellikka7Robert W. Mutter8Hector R. Villarraga9Department of Cardiovascular Medicine Mayo Clinic, Rochester, MN 55905, USAHypertension Unit, Department of Medical Sciences, Città della Salute e della Scienza, University of Torino, 3-10126 Torino, ItalyHypertension Unit, Department of Medical Sciences, Città della Salute e della Scienza, University of Torino, 3-10126 Torino, ItalyDepartment of Cardiovascular Medicine Mayo Clinic, Rochester, MN 55905, USADepartment of Radiation Oncology, Mayo Clinic, Rochester, MN 55905, USADepartment of Radiation Oncology, Mayo Clinic, Rochester, MN 55905, USADepartment of Radiation Oncology, Mayo Clinic, Rochester, MN 55905, USADepartment of Cardiovascular Medicine Mayo Clinic, Rochester, MN 55905, USADepartment of Radiation Oncology, Mayo Clinic, Rochester, MN 55905, USADepartment of Cardiovascular Medicine Mayo Clinic, Rochester, MN 55905, USA<b>1. Background:</b> We sought to determine acute and subacute changes in cardiac function after proton beam (PBT) and photon beam (PhT) radiotherapy (RT) using conventional and two-dimensional speckle tracking echocardiography (2D-STE) in patients with malignant breast and thoracic tumors. <b>2. Methods:</b> Between March 2016 and March 2017, 70 patients with breast or thoracic cancer were prospectively enrolled and underwent transthoracic echocardiography with comprehensive strain analysis at pretreatment, mid-treatment, end of treatment, and 3 months after RT. <b>3. Results:</b> PBT was used to treat 44 patients; PhT 26 patients. Mean ± SD age was 55 ± 12 years; most patients (93%) were women. The median (interquartile range) of the mean heart dose was lower in the PBT than the PhT group (47 [27–79] vs. 217 [120–596] cGy, respectively; <i>p</i> < 0.001). Ejection fraction did not change in either group. Only the PhT group had reduced systolic tissue Doppler velocities at 3 months. 2D-STE showed changes in endocardial and epicardial longitudinal, radial, and circumferential early diastolic strain rate (SRe) in patients undergoing PhT (global longitudinal SRe, pretreatment vs. end of treatment (<i>p</i> = 0.04); global circumferential SRe, pretreatment vs. at 3-month follow-up (<i>p</i> = 0.003); global radial SRe, pretreatment vs. at 3-month follow-up (<i>p</i> = 0.02) for endocardial values). Epicardial strain values decreased significantly only in patients treated with PhT. Patients in the PhT group had a significant decrease in epicardial global longitudinal systolic strain rate (GLSRs) (epicardial GLSRs, at baseline vs. at end of treatment [<i>p</i> = 0.009]) and in GCSRe and GRSRe (epicardial GCSRe, at baseline vs. at 3-month follow-up (<i>p</i> = 0.02); epicardial GRSRe, at baseline vs. at 3-month follow-up (<i>p</i> = 0.03)) during treatment and follow-up. No changes on 2D-STE were detected in the PBT group. <b>4. Conclusions:</b> Patients who underwent PhT but not PBT had reduced tissue Doppler velocities and SRe values during follow-up, suggesting early myocardial relaxation abnormalities. PBT shows promise as a cardiac-sparing RT technology.https://www.mdpi.com/2308-3425/10/10/418early cardiotoxicityradiotherapystrain rate imagingthoracic cancer |
| spellingShingle | Muhannad Aboud Abbasi Giulia Bruno Cristina Di Stefano Laura Garcia Bello Nadia N. Laack Kimberly S. Corbin Thomas J. Whitaker Patricia A. Pellikka Robert W. Mutter Hector R. Villarraga Detection of Early Myocardial Dysfunction by Imaging Biomarkers in Cancer Patients Undergoing Photon Beam vs. Proton Beam Radiotherapy: A Prospective Study Journal of Cardiovascular Development and Disease early cardiotoxicity radiotherapy strain rate imaging thoracic cancer |
| title | Detection of Early Myocardial Dysfunction by Imaging Biomarkers in Cancer Patients Undergoing Photon Beam vs. Proton Beam Radiotherapy: A Prospective Study |
| title_full | Detection of Early Myocardial Dysfunction by Imaging Biomarkers in Cancer Patients Undergoing Photon Beam vs. Proton Beam Radiotherapy: A Prospective Study |
| title_fullStr | Detection of Early Myocardial Dysfunction by Imaging Biomarkers in Cancer Patients Undergoing Photon Beam vs. Proton Beam Radiotherapy: A Prospective Study |
| title_full_unstemmed | Detection of Early Myocardial Dysfunction by Imaging Biomarkers in Cancer Patients Undergoing Photon Beam vs. Proton Beam Radiotherapy: A Prospective Study |
| title_short | Detection of Early Myocardial Dysfunction by Imaging Biomarkers in Cancer Patients Undergoing Photon Beam vs. Proton Beam Radiotherapy: A Prospective Study |
| title_sort | detection of early myocardial dysfunction by imaging biomarkers in cancer patients undergoing photon beam vs proton beam radiotherapy a prospective study |
| topic | early cardiotoxicity radiotherapy strain rate imaging thoracic cancer |
| url | https://www.mdpi.com/2308-3425/10/10/418 |
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