Left ventricular trabecular complexity for risk stratification of cancer therapy-related cardiac dysfunction in...

Area of Science:

• Cardiology
• Oncology
• Medical Imaging

Background:

• Cancer therapy-related cardiac dysfunction (CTRCD) poses a significant risk for breast cancer patients receiving anthracyclines.
• Accurate baseline risk stratification is crucial for managing CTRCD.
• Left ventricular trabecular fractal dimension (LVTFD) from cardiac MRI reflects myocardial complexity and cardiovascular risk.

Purpose of the Study:

• To develop and validate a novel risk score system for baseline CTRCD stratification in breast cancer patients treated with anthracyclines.
• To evaluate the performance of the LVTFD-based score against the Heart Failure Association-International Cardio-Oncology Society (HFA-ICOS) score.

Main Methods:

• A Cox model was utilized to derive and validate a new score incorporating LVTFD, age, hypertension, previous cardiovascular disease, and maximal apical fractal dimension.
• The study included 370 breast cancer patients, with 73 developing CTRCD.
• Performance was compared using the C-index.

Main Results:

• The LVTFD-based score demonstrated superior performance in stratifying CTRCD risk compared to the HFA-ICOS score in both derivation (C-index 0.834 vs. 0.642) and validation cohorts (C-index 0.834 vs. 0.633).
• The LVTFD-based score accurately stratified CTRCD risk, whereas the HFA-ICOS score did not.
• Maximal apical fractal dimension was a key component of the predictive score.

Conclusions:

• The LVTFD-based score is a valuable and alternative tool for baseline risk stratification of CTRCD in breast cancer patients undergoing anthracycline therapy.
• Integrating LVTFD into risk assessment enhances the prediction of cardiac dysfunction in this patient population.