Evidence map›Paper›PMID 37252927›Full record

ArticlePloS one2023

Quantitative cardiovascular magnetic resonance findings and clinical risk factors predict cardiovascular outcomes in breast cancer patients.

Jennifer M Kwan, Amit Arbune, Mariana L Henry, Rose Hu, Wei Wei, Vinh Nguyen, Seohyuk Lee, Juan Lopez-Mattei, Avirup Guha, Steffen Huber and 8 more

Open access · goldAbstract read
In one paragraph

Article in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.9field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 4 citations in OpenAlex.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors at 4 institutions in 2 countries.

Jennifer M KwanSection of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, United States of America.ORCID 0000-0002-4715-1848
Amit ArbuneSection of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, United States of America.
Mariana L HenrySection of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, United States of America.
Rose HuDepartment of Biostatistics, New Haven CT Yale School of Public Health, New Haven, CT, United States of America.
Wei WeiDepartment of Biostatistics, New Haven CT Yale School of Public Health, New Haven, CT, United States of America.
Vinh NguyenSection of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, United States of America.
Seohyuk LeeAllegheny General Hospital, Pittsburg, PA, United States of America.ORCID 0000-0003-3023-1304
Juan Lopez-MatteiLee Memorial Hospital, Fort Meyers, FL, United States of America.
Avirup GuhaMedical College of Georgia, Augusta, Georgia, United States of America.
Steffen HuberDepartment of Radiology, Yale School of Medicine, Section of Medical Oncology Yale School of Medicine, New Haven, CT, United States of America.
Anna S BaderDepartment of Radiology, Yale School of Medicine, Section of Medical Oncology Yale School of Medicine, New Haven, CT, United States of America.ORCID 0000-0002-3807-0261
Judith MeadowsSection of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, United States of America.
Albert SinusasSection of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, United States of America.
Hamid MojibianDepartment of Radiology, Yale School of Medicine, Section of Medical Oncology Yale School of Medicine, New Haven, CT, United States of America.
Dana PetersDepartment of Radiology, Yale School of Medicine, Section of Medical Oncology Yale School of Medicine, New Haven, CT, United States of America.
Maryam LustbergCardiology, Yale School of Medicine, New Haven, CT, United States of America.
Sarah HullSection of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, United States of America.
Lauren A BaldassarreSection of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, United States of America.ORCID 0000-0003-4173-3449
Yale University · USAllegheny General Hospital · USAugusta University · USLee Memorial Hospital · US

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
Institutional Career Development CoreKL2TR001862 · NCATS · YALE UNIVERSITY · PI CANTLEY, LLOYD G, EDELMAN, E. JENNIFER · 2016 to 2025
$12.2M
NCATS NIH HHS KL2 TR001862
6 · The paper itself

Abstract

backgroundCardiac magnetic resonance (CMR) global longitudinal strain and circumferential strain abnormalities have been associated with left ventricular ejection fraction (LVEF) reduction and cardiotoxicity from oncologic therapy. However, few studies have evaluated the associations of strain and cardiovascular outcomes.

objectivesTo assess CMR circumferential and global longitudinal strain (GLS) correlations with cardiovascular outcomes including myocardial infarction, systolic dysfunction, diastolic dysfunction, arrhythmias and valvular disease in breast cancer patients treated with and without anthracyclines and/or trastuzumab therapy.

methodsBreast cancer patients with a CMR from 2013-2017 at Yale New Haven Hospital were included. Patient co-morbidities, medications, and cardiovascular outcomes were obtained from chart review. Biostatistical analyses, including Pearson correlations, competing risk regression model, and competing risk survival curves comparing the two groups were analyzed.

results116 breast cancer with CMRs were included in our analysis to assess differences between Anthracycline/Trastuzumab (AT) (62) treated versus non anthracycline/trastuzumab (NAT) (54) treated patients in terms of imaging characteristics and outcomes. More AT patients 17 (27.4%) developed systolic heart failure compared to the NAT group 6 (10.9%), p = 0.025. Statin use was associated with a significant reduction in future arrhythmias (HR 0.416; 95% CI 0.229-0.755, p = 0.004). In a sub-group of 13 patients that underwent stress CMR, we did not find evidence of microvascular dysfunction by sub-endocardial/sub-epicardial myocardial perfusion index ratio after adjusting for ischemic heart disease.

conclusionsIn our study, CMR detected signs of subclinical cardiotoxicity such as strain abnormalities despite normal LV function and abnormal circumferential strain was associated with adverse cardiovascular outcomes such as valvular disease and systolic heart failure. Thus, CMR is an important tool during and after cancer treatment to identity and prognosticate cancer treatment-related cardiotoxicity.

Indexed as

Breast NeoplasmsCardiovascular DiseasesHeart Failure, SystolicHeart Valve DiseasesVentricular Dysfunction, LeftArrhythmias, CardiacCardiotoxicityFemaleHumansMagnetic Resonance Imaging, CineMagnetic Resonance SpectroscopyRisk FactorsStroke VolumeTrastuzumabVentricular Function, LeftTrastuzumab

Identifiers

PMID37252927
PMCPMC10228774
OpenAlexW4378783639

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.