An international multicentre trial involving Baker Institute researchers, published in the Journal of the American College of Cardiology, shows that myocardial strain (how much the heart muscle deforms with each heartbeat) is the best technique for surveillance of heart function in people undergoing potentially cardiotoxic chemotherapy.
This technique, based on a study of more than 300 patients many of whom had breast cancer, was found to be the best because it alerts clinicians to the early stages of chemotherapy-related toxicity to cardiac muscle problem and allows people to be given appropriate cardio-protection before it’s too late.
Senior study author, cardiologist and Head of Imaging Research at the Institute, Professor Tom Marwick says chemotherapy-related heart dysfunction is a significant cause of death and disability in patients with cancer.
“About 20 per cent of people undergoing anthracycline-based cancer therapy develop a problem with their heart,” he says. “It’s important we have tools to better predict who these people will be, so we can intervene early to protect their heart.”
Right now, the predictive standard is surveillance of left ventricular ejection fraction — how much blood is being pumped out of the left ventricle of the heart. But this traditional surveillance method often does not detect dysfunction until it’s too late for a complete recovery.
This new study is the first randomised trial — the strongest available evidence — that looking at myocardial strain instead gives a much earlier prediction of cancer related cardiac dysfunction or heart failure.
Professor Marwick says it paves the way to consider routine use of this approach for surveillance in patients treated with anthracycline-based cancer therapy, allowing a much more personalised, targeted approach to their care.
