Early cardiac changes following anthracycline chemotherapy in breast cancer: a prospective multi-centre study using advanced cardiac imaging and biochemical markers

Methods 29 chemonaive patients with breast cancer (early stage and metastatic), underwent serial cardiovascular magnetic resonance imaging (for LV volumes/ejection fraction, myocardial oedema and necrosis), advanced echocardiography (for LV strain in addition to standard measurements of LV diastolic function), pro brain natriuretic peptide (pro-BNP) and high-sensitivity Troponin T (hs-TnT, Roche assay) measurements. All tests were conducted at baseline, 1 month, and 3 months following commencement of anthracyclines. 6 normal volunteers (3 male, 3 female) underwent the same CMR protocol. For oedema imaging, a triple inversion recovery fast-spin echo sequence (short-TI inversion recovery) was used in 3 short-axis views of the left ventricle. For assessment of myocardial oedema, the ratio of mean signal intensity (SI) of the myocardium was compared to that of skeletal muscle.