Comprehensive Cardiovascular Magnetic Resonance Tissue Characterization and Cardiotoxicity in Women With Breast...

Area of Science:

• Cardiology
• Oncology
• Radiology

Background:

• Cancer therapies, such as anthracyclines and trastuzumab, can cause cardiac dysfunction.
• Early identification of patients at risk for cancer therapy-related cardiac dysfunction (CTRCD) is crucial.
• Cardiovascular magnetic resonance (CMR) offers detailed myocardial tissue characterization.

Purpose of the Study:

• To investigate changes in CMR tissue biomarkers during breast cancer treatment.
• To determine the association between these biomarkers and the development of CTRCD.

Main Methods:

• Prospective, multicenter cohort study of women with ERBB2-positive breast cancer undergoing anthracycline and trastuzumab therapy.
• Sequential CMR imaging, including T1/T2 mapping and extracellular volume (ECV) assessment, alongside cardiac biomarker measurements (hs-cTnI, BNP).
• Analysis of CMR parameters and biomarkers in relation to CTRCD development, defined by established criteria.

Main Results:

• Myocardial inflammation and edema biomarkers (e.g., ECV, T1, T2 mapping) peaked early in therapy, showing transient increases.
• These changes correlated with ventricular remodeling and elevated B-type natriuretic peptide (BNP) levels.
• No significant association was found between CMR biomarkers and changes in left ventricular ejection fraction (LVEF) or myocardial strain.

Conclusions:

• CMR-detected myocardial inflammation and edema are early, transient findings during specific breast cancer therapies.
• These biomarkers are not reliably associated with traditional measures of cardiac dysfunction (LVEF, strain) or CTRCD risk.
• Further research is needed to refine CMR's role in predicting CTRCD.