GLS vs EF for predicting cardiotoxicity
Research type
Research Study
Full title
Can Global Longitudinal Strain predict trastuzumab adjuvant therapy-induced cardiotoxicity earlier than Ejection Fraction in women with HER2 positive breast cancer?
IRAS ID
252106
Contact name
Chris Ellis
Contact email
Sponsor organisation
Shrewsbury and Telford NHS Trust
Duration of Study in the UK
0 years, 4 months, 1 days
Research summary
Trastuzumab, or Herceptin, is a treatment used in breast cancer patients often in addition to chemotherapy. It is only needed when the cancer cells have a high amount of a protein called Human Epidermal Growth Factor Receptor 2 (HER2). Given alongside chemotherapy or afterwards, Herceptin reduces the risk of cancer returning. When cancer cells have extra HER2 proteins, the cancer cells divide more making the tumour grow. Herceptin stops this from happening by blocking these proteins and stopping them from working. HER2 is found in all cells and controls the body’s natural growth and repair and as a result, Herceptin can also have an adverse effect on the cells in the heart, affecting its function. Known as cardiotoxicity, this is reason for regular cardiac monitoring throughout Herceptin treatment.
The function of the heart can be assessed by measuring the differences in the volume of blood during the contraction and relaxation stages in one heartbeat. This is known as Ejection Fraction (EF). Although considered the gold standard, there can be discrepancies in EF measurements carried out by different staff members; this difference can be as much as 10% and could cause inappropriate suspension of Herceptin treatment. Furthermore, a reduction in EF that would indicate cardiac dysfunction can often be late in surveillance and could miss the time frame in which heart failure treatment could reverse this. Global Longitudinal Strain (GLS) is used to measure function of the heart by assessing how the muscle cells in the heart change shape and dimensions during a heartbeat. GLS is a globally accepted measurement of heart function and published literature is growing to support the use of GLS in detection of cardiotoxicity. Our study will test to see if GLS can detect cardiotoxicity at an earlier time point in follow up than EF.REC name
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REC reference
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