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#1/9
Our recent study - “Serial CMR vs Echo in Cardio-oncology” in iJACC https://bit.ly/3mPh0by . What does it add?
KNOWN: Echo GLS has prognostic value for CTOX during anthracycline/TZM Rx in breast cancer. CMR strain (GCS, GLS) change during therapy.
Our recent study - “Serial CMR vs Echo in Cardio-oncology” in iJACC https://bit.ly/3mPh0by . What does it add?
KNOWN: Echo GLS has prognostic value for CTOX during anthracycline/TZM Rx in breast cancer. CMR strain (GCS, GLS) change during therapy.
#2/9 UNKNOKWN: (1) Are CMR / volume strain changes prognostic for CTOX? (2) How do CMR strain / volume changes compare with Echo Strain / volume changes for prognosis?
#3/9 WHAT WE DID: Prospectively enrolled 125 women, performed sequential echo/MRI same day every 3 months during therapy. Measured GLS/GCS/Volumes by CMR (tagging and feature tracking [FT]) & echo (speckle tracking). Compared prognostic value for CTOX.
![#3/9 WHAT WE DID: Prospectively enrolled 125 women, performed sequential echo/MRI same day every 3 months during therapy. Measured GLS/GCS/Volumes by CMR (tagging and feature tracking [FT]) & echo (speckle tracking). Compared prognostic value for CTOX.](https://pbs.twimg.com/media/EolCXERW8AQIKu1.png "#3/9 WHAT WE DID: Prospectively enrolled 125 women, performed sequential echo/MRI same day every 3 months during therapy. Measured GLS/GCS/Volumes by CMR (tagging and feature tracking [FT]) & echo (speckle tracking). Compared prognostic value for CTOX.")
#4/9 FINDINGS: (1) More CTOX (CREC criteria) identified by CMR (28%) vs echo (22%) -most commonly at 3/6 months into trastuzumab therapy. (2) Association between 2D Echo GLS and GCS and concurrent change in LVEF measured by the respective modality.
#5/9 (3) Concurrent association between change in echo/FT GLS and CTOX. (4) LVESVi was the primary driver of reduction in LVEF, not LVEDVi (5) Change in LVESVi associated with risk of CTOX at subsequent visit (by echo and CMR).
#6/9 (6) Relative change in tagged-CMR GLS/GCS, FT-GCS, and 2D Echo-GLS associated with subsequent CTOX. (7) Continuous relationship between degree of change in strain parameters and the odds of CTOX. Threshold to define future CTOX risk depended on the timing of measurement.
#7/9 (8) Findings remained similar irrespective of CTOX definition (CREC, ASE, ESC) (9) Strain values had incremental value over clinical parameters and LVEF for CTOX, but the greatest benefit was seen with 2D Echo-GLS
#8/9 SUMMARY: 1. MRI strain (tag on FT) prognostic for CTOX during Anth/TZM therapy (NEW) 2. 2D-Echo GLS change assoc with CTOX at the same time (NEW) and future CTOX (OLD) 3. CMR/2D Echo LVESVi prognostic for CTOX (watch volume changes during cancer therapy – PARTIALLY NEW)
#9/9 CONT'D 4. 2D-Echo GLS adds value over LVEF/volumes for subsequent CTOX, but with CMR where volumes and LVEF can be measured accurately incremental value of strain was limited (NEW)
@Docperger
@Houbi_Radiology
@oncocardiology
@CardioOncology
@onco_cardiology
@UofTCardio
@Docperger
@Houbi_Radiology
@oncocardiology
@CardioOncology
@onco_cardiology
@UofTCardio
