Role of Three-Dimensional Echocardiography in Breast Cancer: Comparison With Two-Dimensional Echocardiography, Multiple-Gated Acquisition Scans, and Cardiac Magnetic Resonance Imaging

Abstract

As compared with conventional MUGA, RT3D TTE is a feasible, accurate, and reproducible alternate imaging modality for the serial monitoring of LVEF in patients with breast cancer.

Cardiac magnetic resonance imaging-based myocardial strain study for evaluation of cardiotoxicity in breast cancer patients treated with trastuzumab: A pilot study to evaluate the feasibility of the method

“…Although its high cost and lack of availability precludes its routine clinical use, CMR has been validated for serial monitoring of LVEF and volume in patients with breast cancer receiving trastuzumab, as well as for the characterization of myocardial tissue changes [7,11,12]. Recently, CMR has been also used to monitor right ventricular (RV) ejection fraction (RVEF) in cardiotoxicity [13].…”

Cardiac Imaging: Multimodality Advances and Surveillance Strategies in Detection of Cardiotoxicity

“…Furthermore, 3DE LVEF has been demonstrated to have an improved accuracy over 2DE in detecting LVEF <50% [18], which is frequently the chosen cutoff value to warrant increased cardiac monitoring during the administration of anticancer agents associated with known cardiotoxicity. 3DE has been showed to be feasible, accurate, and reproducible for assessing changes in LV volumes and LVEF when compared with CMR, in women receiving adjuvant trastuzumab after doxorubicin for breast cancer [19]. The reproducibility of 2DE and 3DE, with and without contrast agents, has been studied in the breast cancer population, with non-contrast 3DE LVEF demonstrating lower temporal variability [13].…”

“…Thus, CMR more accurately identified cardiomyopathies among adult survivors previously undiagnosed with cardiac disease using 2DE. On the other hand, compared 3DE LVEF assessment excellent correlation was seen compared to LVEF assessment by CMR [19]. CMR, or alternatively 3DE, should therefore be considered for LVEF confirmation in patients receiving anticancer treatment with a LVEF between 50 and 59% by 2DE, as the cutoff value of 50% of LVEF remains the one used to decide to suspend or discontinue anticancer treatment [30••].…”

The Cardioprotective Role of Naca in the Prevention of Doxorubicin and Trastuzumab Mediated Cardiac Dysfunction

“…21,117 In the emerging field of Cardio-Oncology, a number of basic science studies have evaluated the role of cardiac imaging for the early detection of LV systolic dysfunction due to DOX+TRZ. [12][13][14]118 In an acute murine model of DOX mediated carditoxicity, Neilan et al Previous studies have also evaluated the potential therapeutic effects of other cardioprotective agents. In particular, prior investigations have characterized the potential cardioprotective effects of iron chelating agents, β-blockers, ACE inhibitors, and anti-oxidants including Probucol.…”

“…13,[121][122][123][124] The clincal use of ACE inhibitors has led to significant improvements in overall morbidity and mortality in cancer patients who develop heart failure. [116][117][118][119] Patients who suffer from heart failure, including DOX induced cardiomyopathy are often treated with ACE inhibitors following the development of LV systolic dysfunction. 125 Similarily, β-blockers have also been evaluated for their efficacy in treating heart failure, and are often used following the development of systolic dysfunction.…”