Rachel Knol, Laurine T van der Wal, Jozine M Ter Maaten, Geertruida H de Bock, Saskia W M C Maass, Daan Brandenbarg
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引用次数: 0
Abstract
Background: With a growing population of breast cancer survivors, it is important to acknowledge long-term consequences of breast cancer treatment, including left ventricular systolic dysfunction (LVSD). Although echocardiography is a reliable technique to diagnose LVSD, its limited accessibility in primary care poses challenges.
Methods: A cross-sectional diagnostic accuracy study among 350 long-term breast cancer survivors, at least 5 years after breast cancer diagnosis, comparing the diagnostic performance of index tests ECG and N-terminal pro B-type natriuretic peptide (NT-proBNP) to the reference test echocardiography. LVSD was defined as left ventricular ejection fraction (LVEF) less than 54% or LVEF less than 50% on echocardiography.
Results: The median age at time of investigation was 63 years (IQR 57-68), with a median follow-up duration since breast cancer diagnosis of 10 years (IQR 7-14). An abnormal ECG demonstrated a sensitivity of 63.0% (IQR 48.7-75.7), a corresponding specificity of 51.7 (IQR 45.8-57.6) and a negative likelihood ratio of 0.7 (IQR 0.5-1.0) for detecting a LVEF less than 54%. An abnormal ECG showed a sensitivity of 75.0 (IQR 47.6-92.7), a corresponding specificity of 50.6 (IQR 45.1-56.2) and a negative likelihood ratio of 0.5 (0.2-1.2) for detecting LVSD defined as LVEF less than 50%. The area under the curve for NT-proBNP was 0.59 (95% confidence interval: 0.50-0.68) for detecting LVEF less than 54% and 0.56 (95% confidence interval: 0.39-0.74) for detecting LVEF less than 50%.
Discussion: ECG and NT-proBNP are inadequate diagnostic tools to screen for LVSD among asymptomatic long-term breast cancer survivors.
期刊介绍:
Journal of Cardiovascular Medicine is a monthly publication of the Italian Federation of Cardiology. It publishes original research articles, epidemiological studies, new methodological clinical approaches, case reports, design and goals of clinical trials, review articles, points of view, editorials and Images in cardiovascular medicine.
Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.