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Changes in vascular function and correlation with cardiotoxicity in women with newly diagnosed breast cancer undergoing HER2-directed therapy with and without anthracycline/cyclophosphamide.
Hazim, Antonious; Nhola, Lara F; Kailash, Vidur; Zhang, Song; Sandhu, Nicole P; Lerman, Amir; Loprinzi, Charles L; Ruddy, Kathryn J; Villarraga, Hector R; Lewis, Bradley; Herrmann, Joerg.
Afiliación
  • Hazim A; Department of Oncology, Mayo Clinic, Rochester, MN, USA.
  • Nhola LF; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.
  • Kailash V; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.
  • Zhang S; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.
  • Sandhu NP; Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
  • Lerman A; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.
  • Loprinzi CL; Department of Oncology, Mayo Clinic, Rochester, MN, USA.
  • Ruddy KJ; Department of Oncology, Mayo Clinic, Rochester, MN, USA.
  • Villarraga HR; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.
  • Lewis B; Department of Biostatistics, Mayo Clinic, Rochester, MN, USA.
  • Herrmann J; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.
Eur Heart J Open ; 4(1): oead130, 2024 Jan.
Article en En | MEDLINE | ID: mdl-38239934
ABSTRACT

Aims:

The objective of this study was to assess the effect of HER2-directed therapy (HER2-Tx) on peripheral vasoreactivity and its correlation with cardiac function changes and the additive effects of anthracycline/cyclophosphamide (AC) therapy and baseline cardiovascular risk. Methods and

results:

Single-centre, prospective cohort study of women with newly diagnosed stage 1-3 HER2-positive breast cancer undergoing HER2-Tx +/- AC. All participants underwent baseline and 3-monthly evaluations with Endo-Peripheral Arterial Tonometry (Endo-PAT), vascular biomarkers [C-type natriuretic peptide (CNP) and neuregulin-1 beta (NRG-1ß)], and echocardiography. Cardiotoxicity was defined as a decrease in the left ventricular ejection fraction (LVEF) of >10% to a value <53%. Of the 47 patients enrolled, 20 (43%) received AC in addition to HER2-Tx. Deterioration of reactive hyperaemia index (RHI) on Endo-PAT by ≥20% was more common in patients receiving HER-Tx plus AC than HER2-Tx alone (65% vs. 22%; P = 0.003). A decrease in CNP and log NRG-1ß levels by 1 standard deviation did not differ significantly between the AC and non-AC groups (CNP 20.0% vs. 7.4%; P = 0.20 and NRG-1ß 15% vs. 11%; P = 0.69) nor did GLS (35% vs. 37%; P = 0.89). Patients treated with AC had a significantly lower 3D LVEF than non-AC recipients as early as 3 months after exposure (mean 59.3% (SD 3) vs. 63.8% (SD 4); P = 0.02). Reactive hyperaemia index and GLS were the only parameters correlating with LVEF change.

Conclusion:

Combination therapy with AC, but not HER2-Tx alone, leads to a decline in peripheral vascular and cardiac function. Larger studies will need to define more precisely the causal correlation between vascular and cardiac function changes in cancer patients.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Diagnostic_studies / Observational_studies / Risk_factors_studies Idioma: En Revista: Eur Heart J Open Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Diagnostic_studies / Observational_studies / Risk_factors_studies Idioma: En Revista: Eur Heart J Open Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido