Digital Poster 7: Right ventricular CMR strain analysis detects subclinical myocardial damage after anthracycline-based chemotherapy in breast cancer patients

Wednesday, January 29, 2025

5:30 PM – 6:00 PM East Coast USA Time

Location: Blue Room PreFunction

Presenting Author(s)

DA

Destina Gizem Aydemir, MD

Resident in Training in Radiology
University Medical Center Hamburg-Eppendorf (UKE), Germany

Primary Author(s)

DA

Destina Gizem Aydemir, MD

Resident in Training in Radiology
University Medical Center Hamburg-Eppendorf (UKE), Germany

Co-Author(s)

Jennifer Erley, MD

radiologist resident/ Dr.med
University Medical Center Hamburg-Eppendorf, Germany
Enver G. Tahir, MD

MD
University Medical Center Hamburg-Eppendorf, Germany
GA

Gerhard Adam, MD

MD
University Medical Center Hamburg-Eppendorf, Germany
AB

Antonia Beitzen-Heineke, MD

Specialty physician
University Medical Center Hamburg-Eppendorf, Germany
HC

Hang Chen, MSc

Scientist
UKE, Germany

Background: Cardiovascular magnetic resonance myocardial feature tracking (CMR-FT) is a novel method for evaluating myocardial deformation. In breast cancer patients, anthracycline-based chemotherapy may lead to a cancer therapy-related cardiac dysfunction. The purpose of this study was to investigate subclinical myocardial damage after anthracycline-based chemotherapy in breast cancer patients by analyzing right ventricular (RV) function using CMR-FT.

Methods: This prospective, single-center study involved 30 female breast cancer patients with a mean age of 50±11 years who received anthracycline-based chemotherapy. CMR was performed on all patients before initiating therapy, with a follow-up 12 months thereafter. Right ventricular ejection fraction (RVEF), end-diastolic volume (RVEDV), end-systolic volume (RVESV), and stroke volume (RVSV) were measured and indexed to the body surface area. Feature Tracking (FT) was utilized to evaluate the global longitudinal strain (GLS) on four-chamber long-axis cine images along with the global radial strain (GRS) and global circumferential strain (GCS) in short-axis cine images. The Shapiro–Wilk test was performed to verify normal distribution. Paired t-tests were used to assess the differences in strain values from baseline to follow-up.

Results: After 12 months, only 7 out of 30 patients showed a decline in RVEF and mean RVEF of all patients did not change (54.3 ± 5.7% vs. 55.8 ± 5.7%, p = 0.2). All patients with a decline in RVEF demonstrated an elevated GLS in the follow-up examination. The mean GLS of all patients significantly increased from baseline to follow-up after chemotherapy (-25.2 ± 3.9% vs. -20.6 ± 4.4%, p < 0.001). GRS showed no significant change after chemotherapy (18.4 ± 7.3% at baseline vs. 20.2 ± 6.6 % at follow-up, p = 0.09). GCS showed no increase in the follow-up examination (-11.1± 3.6% vs. -12.3 ± 3.1%). Furthermore, no significant difference was observed for indexed RVEDV, RVESV and RVSV between baseline and follow-up CMR assessments.

Conclusion: RV strain analysis using CMR-FT is effective in detecting myocardial damage after anthracycline-based chemotherapy. Importantly, changes in RV-GLS might serve as an early indicator of subclinical cardiotoxicity in breast cancer patients.