Echo-loop of subclinical cardiovascular toxicity in women associated with HER2-positive breast cancer therapy
Эхо-петля субклинической сердечно-сосудистой токсичности у женщин, связанной с терапией HER2-позитивного рака молочной железы
Pershukov I.V. Akbalaeva B.A. Shulzhenko L.V. Batyraliev T.A. Gurovich O.V. Vinogradskaya V.V. Karben Z.A. Fetzer D.V. Kuznetsova T.N. Ivanenkova E.Yu. Raimbek uulu N. Kvasova M.V. Kalmatov R.K. Imetova Zh.B. Mamatova S.M. Dzhainakbaev N.T. Seydalin A.O. Rakhalskaya N.N.
2024Silicea-Poligraf
Cardiovascular Therapy and Prevention (Russian Federation)
2024#23Issue 657 - 65 pp.
Aim. To assess the incidence and timing of subclinical cardiac dysfunction associated with therapy for HER2-positive locally advanced or metastatic breast cancer, and to analyze the difference in time from significant reduction in left ventricular (LV) global longitudinal strain (GLS) to significant reduction in LV ejection fraction (LVEF) (cardiotoxicity echo-loop). Material and methods. A total of 187 women 58±11 years without baseline cardiac dysfunction with verified HER2-positive locally advanced or metastatic breast cancer who received sequential adjuvant therapy with doxorubicin+cyclophosphamide, docetaxel+trastuzumab and trastuzumab monotherapy were followed up in 4 centers in four countries within 12 months with regular (every 3 weeks) speckle-tracking echocardiographic monitoring. Results. Subclinical cardiac dysfunction associated with breast cancer therapy (CTRCD) appears in each block of therapy after the first course. Its frequency increases significantly after each subsequent course compared to the previous one. By the end of the 4th course in each block of therapy, subclinical CTRCD is noted from 24,6% (almost every 4th patient in the chemotherapy block) to 32,6-33,7% (almost every 3rd patient in the chemotherapy and targeted therapy blocks). In 24 out of 25 cases of severe subclinical CTRCD (96%) with a fall in LVEF <40%, a decrease in LV GLS >15% was preceded. The time difference from a decrease in LV GLS to a decrease in LVEF <40% (cardiotoxicity echo loop”) ranges from 5 to 16 weeks depending on the cancer therapy option. Conclusion. Until recently, the period of identified moderate subclinical cardiac dysfunction was not used to prescribe therapy for the prevention and treatment of cardiotoxicity. Enhanced speckle-tracking echocardiographic monitoring may reduce the incidence of severe subclinical and overt clinical cardiac dysfunction. Guidelines for cardiotoxicity monitoring should be reviewed to reduce the incidence of severe cardiac complications of cancer therapy.
cancer therapy-related cardiac dysfunction , cardiac dysfunction , cardiovascular toxicity , HER2-positive breast cancer , left ventricular global longitudinal strain , speckle tracking echocardiography
Text of the article Перейти на текст статьи
Bobrov District Hospital., Voronezh region, Bobrov, Russian Federation
Kazakhstan-Russian Medical University, Almaty, Kazakhstan
Osh State University, Osh, Kyrgyzstan
Aliyev Osh Cardio Medical Center, Osh, Kyrgyzstan
Research Institute, S. V. Ochapovsky Regional Clinical Hospital № 1, Krasnodar, Russian Federation
Kuban State Medical University, Krasnodar, Russian Federation
Salymbekov University, Bishkek, Kyrgyzstan
Burdenko Voronezh State Medical University, Voronezh, Russian Federation
City of Health Clinic, Voronezh, Russian Federation
Sanko University, Sehitkamil, Gaziantep, Turkey
City Clinical Hospital № 52, Moscow, Russian Federation
Voronezh Regional Clinical Hospital № 1, Voronezh, Russian Federation
Bobrov District Hospital.
Kazakhstan-Russian Medical University
Osh State University
Aliyev Osh Cardio Medical Center
Research Institute
Kuban State Medical University
Salymbekov University
Burdenko Voronezh State Medical University
City of Health Clinic
Sanko University
City Clinical Hospital № 52
Voronezh Regional Clinical Hospital № 1
10 лет помогаем публиковать статьи Международный издатель
Книга Публикация научной статьи Волощук 2026 Book Publication of a scientific article 2026