Coronary Flow Velocity Reserve Declines After Anthracycline Therapy in Breast Cancer Patients
Christopher Yu, MBBS,
Prajith Jeyaprakash, MBBS,
Koya Ozawa, MD, PhD,
Tomoko Negishi, MD,
Dhanusha Sabanathan, MBBS, PhD,
John Park, MBBS, PhD,
Jennifer Man, MBBS, PhD,
Anuradha Vasista, MBBS, PhD,
Faraz Pathan, MBBS, PhD,
Kazuaki Negishi, MD, PhD, MSc
Affiliations
Christopher Yu, MBBS
Sydney Medical School, Charles Perkins Centre Nepean, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia; Cardiology Department, Nepean Hospital, Sydney, New South Wales, Australia
Prajith Jeyaprakash, MBBS
Sydney Medical School, Charles Perkins Centre Nepean, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia; Cardiology Department, Nepean Hospital, Sydney, New South Wales, Australia
Koya Ozawa, MD, PhD
Sydney Medical School, Charles Perkins Centre Nepean, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia; Cardiology Department, Nepean Hospital, Sydney, New South Wales, Australia
Tomoko Negishi, MD
Sydney Medical School, Charles Perkins Centre Nepean, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia; Cardiology Department, Nepean Hospital, Sydney, New South Wales, Australia
Dhanusha Sabanathan, MBBS, PhD
Medical Oncology Department, Nepean Hospital, Sydney, New South Wales, Australia
John Park, MBBS, PhD
Medical Oncology Department, Nepean Hospital, Sydney, New South Wales, Australia
Jennifer Man, MBBS, PhD
Medical Oncology Department, Nepean Hospital, Sydney, New South Wales, Australia
Anuradha Vasista, MBBS, PhD
Medical Oncology Department, Nepean Hospital, Sydney, New South Wales, Australia
Faraz Pathan, MBBS, PhD
Sydney Medical School, Charles Perkins Centre Nepean, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia; Cardiology Department, Nepean Hospital, Sydney, New South Wales, Australia
Kazuaki Negishi, MD, PhD, MSc
Sydney Medical School, Charles Perkins Centre Nepean, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia; Cardiology Department, Nepean Hospital, Sydney, New South Wales, Australia; Corresponding author: Professor Kazuaki Negishi, The University of Sydney, Nepean Clinical School, Level 5, South Block, PO Box 63 Penrith, New South Wales 2751, Australia. Tel.: +61 2 4734 4278; fax: +61 2 4734 2614.
Anthracycline therapy (ANT) is associated with cancer therapy-related cardiac dysfunction. Coronary flow velocity reserve (CFVR) has shown prognostic utility in non-cancer cohorts, but no data have been obtained in a cardio-oncology setting. We investigated the acute effect of ANT on CFVR in breast cancer patients. A total of 12 female breast cancer patients undergoing ANT had pre- and post-ANT CFVR assessment. A significant decline in CFVR occurred (baseline: 2.66 ± 0.41 vs post-ANT: 2.47 ± 0.37, P = 0.016). This prospective study is the first to identify ANT-related coronary physiology changes in humans. Further studies are required to determine their clinical significance. Résumé: Le traitement par l’anthracycline est associé à une dysfonction cardiaque liée au traitement anticancéreux. La réserve de débit coronaire a démontré son utilité pronostique dans les cohortes sans cancer, mais aucune donnée n’a été obtenue dans un contexte de cardio-oncologie. Nous avons étudié l’effet aigu de l’anthracycline sur la réserve de débit coronaire chez des patientes atteintes d’un cancer du sein. La réserve de débit coronaire a été évaluée avant et après le traitement par l’anthracycline chez un total de 12 femmes atteintes d’un cancer du sein. Un déclin important de la réserve de débit coronaire est survenu (valeur initiale de 2,66 ± 0,41 par rapport à 2,47 ± 0,37 après le traitement par l’anthracycline, p = 0,016). Cette étude prospective est la première à déceler des changements dans la physiologie coronarienne liés à l’anthracycline chez les humains. D’autres études sont nécessaires pour en déterminer la portée clinique.
