Does diastolic dysfunction precede systolic dysfunction in trastuzumab-induced cardiotoxicity? Assessment with multigated radionuclide angiography (MUGA)

E.J. Reuvekamp, Ben Bulten, A.A. Nieuwenhuis, M.R. Meekes, A.F. de Haan, J. Tol, A.H. Maas, S.E. Elias-Smale, Lioe-Fee de Geus-Oei

Research output: Contribution to journalArticleAcademicpeer-review

11 Citations (Scopus)
55 Downloads (Pure)

Abstract

Background Trastuzumab is successfully used for the treatment of HER2-positive breast cancer. Because of its association with cardiotoxicity, LVEF is monitored by MUGA, though this is a relatively late measure of cardiac function. Diastolic dysfunction (DD) is believed to be an early predictor of cardiac impairment. We evaluate the merit of MUGA-derived diastolic function parameters in the early detection of trastuzumab-induced cardiotoxicity (TIC). Methods and Results 77 trastuzumab-treated patients with normal baseline systolic and diastolic function were retrospectively selected (n = 77). All serial MUGA examinations were re-analyzed for systolic and diastolic function parameters. 36 patients (47%) developed SD and 45 patients (58%) DD during treatment. Both systolic and diastolic parameters significantly decreased. Of the patients with SD, 24 (67%) also developed DD. DD developed prior to systolic impairment in 54% of cases, in 42% vice versa, while time to occurrence did not differ significantly (P = .52). This also applied to the subgroup of advanced stage breast cancer patients (P = .1). Conclusions Trastzumab-induced SD and DD can be detected by MUGA. An impairment of MUGA-derived diastolic parameters does not occur prior to SD and therefore cannot be used as earlier predictors of TIC.
Original languageEnglish
Pages (from-to)824-832
JournalJournal of nuclear cardiology
Volume23
Issue number4
DOIs
Publication statusPublished - 6 Jun 2016

Fingerprint

Radionuclide Angiography
Breast Neoplasms
Trastuzumab
Cardiotoxicity
Therapeutics

Keywords

  • METIS-312257
  • IR-99800

Cite this

Reuvekamp, E.J. ; Bulten, Ben ; Nieuwenhuis, A.A. ; Meekes, M.R. ; de Haan, A.F. ; Tol, J. ; Maas, A.H. ; Elias-Smale, S.E. ; de Geus-Oei, Lioe-Fee. / Does diastolic dysfunction precede systolic dysfunction in trastuzumab-induced cardiotoxicity? Assessment with multigated radionuclide angiography (MUGA). In: Journal of nuclear cardiology. 2016 ; Vol. 23, No. 4. pp. 824-832.
@article{d4ed8004c7d64382a00ee85903e2de37,
title = "Does diastolic dysfunction precede systolic dysfunction in trastuzumab-induced cardiotoxicity? Assessment with multigated radionuclide angiography (MUGA)",
abstract = "Background Trastuzumab is successfully used for the treatment of HER2-positive breast cancer. Because of its association with cardiotoxicity, LVEF is monitored by MUGA, though this is a relatively late measure of cardiac function. Diastolic dysfunction (DD) is believed to be an early predictor of cardiac impairment. We evaluate the merit of MUGA-derived diastolic function parameters in the early detection of trastuzumab-induced cardiotoxicity (TIC). Methods and Results 77 trastuzumab-treated patients with normal baseline systolic and diastolic function were retrospectively selected (n = 77). All serial MUGA examinations were re-analyzed for systolic and diastolic function parameters. 36 patients (47{\%}) developed SD and 45 patients (58{\%}) DD during treatment. Both systolic and diastolic parameters significantly decreased. Of the patients with SD, 24 (67{\%}) also developed DD. DD developed prior to systolic impairment in 54{\%} of cases, in 42{\%} vice versa, while time to occurrence did not differ significantly (P = .52). This also applied to the subgroup of advanced stage breast cancer patients (P = .1). Conclusions Trastzumab-induced SD and DD can be detected by MUGA. An impairment of MUGA-derived diastolic parameters does not occur prior to SD and therefore cannot be used as earlier predictors of TIC.",
keywords = "METIS-312257, IR-99800",
author = "E.J. Reuvekamp and Ben Bulten and A.A. Nieuwenhuis and M.R. Meekes and {de Haan}, A.F. and J. Tol and A.H. Maas and S.E. Elias-Smale and {de Geus-Oei}, Lioe-Fee",
note = "Open access",
year = "2016",
month = "6",
day = "6",
doi = "10.1007/s12350-015-0164-x",
language = "English",
volume = "23",
pages = "824--832",
journal = "Journal of nuclear cardiology",
issn = "1071-3581",
publisher = "Springer",
number = "4",

}

Does diastolic dysfunction precede systolic dysfunction in trastuzumab-induced cardiotoxicity? Assessment with multigated radionuclide angiography (MUGA). / Reuvekamp, E.J.; Bulten, Ben; Nieuwenhuis, A.A.; Meekes, M.R.; de Haan, A.F.; Tol, J.; Maas, A.H.; Elias-Smale, S.E.; de Geus-Oei, Lioe-Fee.

In: Journal of nuclear cardiology, Vol. 23, No. 4, 06.06.2016, p. 824-832.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Does diastolic dysfunction precede systolic dysfunction in trastuzumab-induced cardiotoxicity? Assessment with multigated radionuclide angiography (MUGA)

AU - Reuvekamp, E.J.

AU - Bulten, Ben

AU - Nieuwenhuis, A.A.

AU - Meekes, M.R.

AU - de Haan, A.F.

AU - Tol, J.

AU - Maas, A.H.

AU - Elias-Smale, S.E.

AU - de Geus-Oei, Lioe-Fee

N1 - Open access

PY - 2016/6/6

Y1 - 2016/6/6

N2 - Background Trastuzumab is successfully used for the treatment of HER2-positive breast cancer. Because of its association with cardiotoxicity, LVEF is monitored by MUGA, though this is a relatively late measure of cardiac function. Diastolic dysfunction (DD) is believed to be an early predictor of cardiac impairment. We evaluate the merit of MUGA-derived diastolic function parameters in the early detection of trastuzumab-induced cardiotoxicity (TIC). Methods and Results 77 trastuzumab-treated patients with normal baseline systolic and diastolic function were retrospectively selected (n = 77). All serial MUGA examinations were re-analyzed for systolic and diastolic function parameters. 36 patients (47%) developed SD and 45 patients (58%) DD during treatment. Both systolic and diastolic parameters significantly decreased. Of the patients with SD, 24 (67%) also developed DD. DD developed prior to systolic impairment in 54% of cases, in 42% vice versa, while time to occurrence did not differ significantly (P = .52). This also applied to the subgroup of advanced stage breast cancer patients (P = .1). Conclusions Trastzumab-induced SD and DD can be detected by MUGA. An impairment of MUGA-derived diastolic parameters does not occur prior to SD and therefore cannot be used as earlier predictors of TIC.

AB - Background Trastuzumab is successfully used for the treatment of HER2-positive breast cancer. Because of its association with cardiotoxicity, LVEF is monitored by MUGA, though this is a relatively late measure of cardiac function. Diastolic dysfunction (DD) is believed to be an early predictor of cardiac impairment. We evaluate the merit of MUGA-derived diastolic function parameters in the early detection of trastuzumab-induced cardiotoxicity (TIC). Methods and Results 77 trastuzumab-treated patients with normal baseline systolic and diastolic function were retrospectively selected (n = 77). All serial MUGA examinations were re-analyzed for systolic and diastolic function parameters. 36 patients (47%) developed SD and 45 patients (58%) DD during treatment. Both systolic and diastolic parameters significantly decreased. Of the patients with SD, 24 (67%) also developed DD. DD developed prior to systolic impairment in 54% of cases, in 42% vice versa, while time to occurrence did not differ significantly (P = .52). This also applied to the subgroup of advanced stage breast cancer patients (P = .1). Conclusions Trastzumab-induced SD and DD can be detected by MUGA. An impairment of MUGA-derived diastolic parameters does not occur prior to SD and therefore cannot be used as earlier predictors of TIC.

KW - METIS-312257

KW - IR-99800

U2 - 10.1007/s12350-015-0164-x

DO - 10.1007/s12350-015-0164-x

M3 - Article

VL - 23

SP - 824

EP - 832

JO - Journal of nuclear cardiology

JF - Journal of nuclear cardiology

SN - 1071-3581

IS - 4

ER -