Early Detection of Heart Problems in Cancer Patients Receiving Chemotherapy

Strain Echocardiogram in Early Detection of Left Ventricular Dysfunction in Cancer Patients Receiving Chemotherapy

Subjects will include patients diagnosed with breast cancer or hematological cancer who are planned for chemotherapy treatment with anthracycline or trastuzumab; and who have one or more risk factors for cardiovascular disease. Subjects will received an extra echocardiogram to determine if heart problems can be detected earlier.

• Patients scheduled for potentially cardiotoxic chemotherapy would receive a baseline echocardiogram as per standard protocol which should be covered by the routine insurance
• Follow-up with an extra echocardiogram for research purposes would be performed after 2 cycles of that chemotherapy - supplied by the study
• Clinical assessment at 3 to 6 months including repeat echocardiography as per standard care with the research question as whether any differences in strain pattern between pre-chemo and post 2 cycles studies all identify patients who are more likely to have cardiac issues later.
• Patients will have standard of care visits at 3 month, 6 month and 12 month and will be evaluated for cardiac status and survival.
• Patient records will be reviewed at 5 years to check cardiac status and survival.

Inclusion Criteria:

• Males and females 18 years and above

• Willing and able to provide consent

• Able to read

• Patients diagnosed with breast cancer or hematological cancer who are planned for chemotherapy treatment with anthracycline or trastuzumab.

• Patients at increased risk of cardiotoxicity with one or more risk factors for heart disease:

  • LVEF 50-54% by baseline echocardiogram
  • Age ≥ 65
  • BMI ≥ 30 kg/m2
  • Current or prior anti-hypertensive therapy
  • Diagnosis of coronary artery disease (CAD)
  • Diabetes Mellitus
  • Atrial fibrillation/flutter

Exclusion Criteria:

• Children
• Patients who are pregnant
• Only single encounter without follow up
• Cancer diagnosis other than breast or hematological cancer
• Chemotherapy treatment other than anthracycline or trastuzumab
• No prior chemotherapy treatment