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2037 delayed contrast enhancement cardiac magnetic resonance imaging in trastuzumab induced cardiomyopathy

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Journal of Cardiovascular Magnetic Resonance BioMed Central Open Access Meeting abstract 2037 Delayed contrast enhancement cardiac magnetic resonance imaging IN trastuzumab induced cardiomyopathy Davinder S Jassal*1, Nazanin Fallah-Rad2,3, Matthew Lytwyn2, Tielan Fang2 and Iain Kirkpatrick4 Address: 1St Boniface General Hospital, University of Manitoba, Winnipeg, MB, Canada, 2Institute of Cardiovascular Sciences,, St Boniface General Hospital, Winnipeg, MB, Canada, 3University of Manitoba, Wininpeg, MB, Canada and 4Department of Radiology, St Boniface General Hospital, Winnipeg, MB, Canada * Corresponding author from 11th Annual SCMR Scientific Sessions Los Angeles, CA, USA 1–3 February 2008 Published: 22 October 2008 Journal of Cardiovascular Magnetic Resonance 2008, 10(Suppl 1):A306 doi:10.1186/1532-429X-10-S1-A306

Abstracts of the 11th Annual SCMR Scientific Sessions - 2008

Meeting abstracts – A single PDF containing all abstracts in this Supplement is available here. http://www.biomedcentral.com/content/pdf/1532-429X-10-S1-info.pdf This abstract is available from: http://jcmr-online.com/content/10/S1/A306 © 2008 Jassal et al; licensee BioMed Central Ltd Background Trastuzumab (Herceptin), an antagonist to the human epidermal growth factor (HER2) receptor, significantly decreases the rates of breast cancer recurrence and mortality by 50% Despite therapeutic benefits, the risk of cardiotoxicity with Trastuzumab ranges from 10–15% when administered in combination with anthracyline therapy Although serial multiple gated acquisition scans are widely used to monitor cardiac dysfunction in breast cancer patients, cardiac MRI (CMR) is becoming the gold standard for the non-invasive assessment of left ventricular (LV) systolic dysfunction in dilated cardiomyopathies performed after 10 minutes of 0.2 mmol/kg injection of Gadolinium in all patients to assess scar formation Results The total population included 20 patients (mean age 42 ± 12 years, range 30 to 64 years) At the time of diagnosis of Trastuzumab induced cardiomyopathy, the LV cavities were dilated with moderate to severe global LV systolic dysfunction on CMR The mean LVEF was 29 ± 4% Subepicardial linear delayed enhancement was present in the lateral portion of the left ventricles in all 20 patients suggesting the presence of Trastuzumab induced myocarditis (Figure 1) Objective To describe the utility of CMR in the assessment of Trastuzumab induced cardiomyopathy Methods Between 2005–2006 inclusive, 160 breast cancer patients who received Trastuzamab in addition to anthracyline based adjuvant therapy were identified at a tertiary care oncology centre Of the total population, 20 patients were identified with Trastuzumab induced cardiomyopathy based on LV ejection fraction (EF) less than 40% on either serial MUGA or echocardiography Cardiac MRI was performed on all 20 patients using a 1.5 T scanner to determine LV volumes and systolic function Delayedenhancement inversion recovery CMR (DE-CMR) was Conclusion DE-CMR is a novel way of detecting early changes in the myocardium due to Trastuzumab induced cardiotoxicity Future studies are required to validate identification of positive delayed enhancement using CMR as a subclinical marker for future LV dysfunction in this select population Page of (page number not for citation purposes) Journal of Cardiovascular Magnetic Resonance 2008, 10(Suppl 1):A306 http://jcmr-online.com/content/10/S1/A306 Figure Publish with Bio Med Central and every scientist can read your work free of charge "BioMed Central will be the most significant development for disseminating the results of biomedical researc h in our lifetime." Sir Paul Nurse, Cancer Research UK Your research papers will be: available free of charge to the entire biomedical community peer reviewed and published immediately upon acceptance cited in PubMed and archived on PubMed Central yours — you keep the copyright BioMedcentral Submit your manuscript here: http://www.biomedcentral.com/info/publishing_adv.asp Page of (page number not for citation purposes) ...Journal of Cardiovascular Magnetic Resonance 2008, 10(Suppl 1):A306 http://jcmr-online.com/content/10/S1/A306 Figure Publish with Bio Med Central and... charge "BioMed Central will be the most significant development for disseminating the results of biomedical researc h in our lifetime." Sir Paul Nurse, Cancer Research UK Your research papers... acceptance cited in PubMed and archived on PubMed Central yours — you keep the copyright BioMedcentral Submit your manuscript here: http://www.biomedcentral.com/info/publishing_adv.asp Page of

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