A Prospective Study of Breast Cancer Patients with Abnormal Myocardial Deformation treated with Anthracycline and Trastuzumab-based chemotherapies

A Prospective Study of Breast Cancer Patients with Abnormal Myocardial Deformation treated with Anthracycline and Trastuzumab-based chemotherapies The Cardio-Oncology program at Northwestern offers care to cancer patients who develop cardiac toxicities from chemotherapy. There are approximately 1000 new cases of breast cancer diagnosed every year at Northwestern. Of these, approximately 200 women will have the tumor marker for HER2 positive, necessitating treatment with anthracycline and trastuzumab-based chemotherapies, both known to cause cardiac toxicities. Breast cancer patients at Northwestern undergo “cardio-oncology echocardiograms” which incorporate advanced left ventricular assessment by utilizing deformation or strain imaging during chemotherapy treatment for surveillance of cardiac toxicities. The aims of this project are (1) to create a database of both clinical and echocardiographic variables to better understand the risk factors that lead to cardiac toxicities in breast cancer patients, (2) to propose an algorithm for management changes based on strain imaging, and (3) to determine if patients identified with early cardiac toxicity and treated with prophylactic beta-blocker therapy carvedilol will delay or prevent a drop in LV EF and the development of clinical heart failure. This study utilizes state-of-the-art 2D speckle tracking strain to measure preclinical changes in regional and global left ventricular function that occur before a decrease in the ejection fraction and to study the role of strain imaging in risk assessment and guiding management.