Risk Prediction Models of Cardiotoxicity in Patients With Breast Cancer: Multicenter Prospective CHECK HEART-BC Study.

JACC. Asia Pub Date : 2025-09-29 DOI:10.1016/j.jacasi.2025.08.018

Yosuke Terui, Kotaro Nochioka, Hideki Ota, Hiroshi Tada, Haruka Sato, Satoshi Miyata, Shigeru Toyoda, Shu Inami, Akihiro Nomura, Masaya Shimojima, Yasuhiro Izumiya, Yusuke Kodama, Takeshi Kitai, Kaoru Iwabuchi, Shu Suzuki, Daisuke Kitano, Keisuke Kida, Kiyotaka Shibuya, Takuya Oikawa, Takeru Nabeta, Toshiyuki Yano, Hiroyuki Iwano, Masayoshi Oikawa, Tatsuhiro Shibata, Yutaka Miura, Yoshito Ogihara, Nobuyuki Komiyama, Hiroshi Kato, Koji Higuchi, Sakiko Miyazaki, Yugo Yamashita, Satoshi Yasuda, Koichiro Sugimura

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引用次数: 0

Abstract

Background: Early detection and treatment of cardiotoxicity are essential for reducing cardiac events. However, a reliable predictive model for cardiotoxicity in patients with breast cancer receiving chemotherapy is lacking.

Objectives: In this study, we aimed to develop a risk prediction model and establish effective surveillance for cardiotoxicity in patients with breast cancer undergoing chemotherapy.

Methods: Patients with breast cancer scheduled for neoadjuvant and/or adjuvant chemotherapy were prospectively screened at 25 participating institutions between August 2017 and March 2020. Cardiotoxicity was defined as a reduction in left ventricular ejection fraction of >10% from baseline to a value <53%.

Results: The study included 559 chemotherapy-naïve female patients. Cardiotoxicity was observed in 46 of 559 patients (8.2%) during a median follow-up period of 366 days (Q1-Q3: 365-367 days). The CHECK HEART (Comprehensive Heart Imaging to Evaluate Cardiac Damage Linked With Chemotherapy in Breast Cancer Patients) score consisted of 6 variables: heart rate, left ventricular global longitudinal strain, left ventricular end-systolic and end-diastolic diameters, right ventricular fractional area change, and treatment with anthracycline and trastuzumab. The time-dependent area under the receiver operating characteristic curve (AUC) at 12 months based on pretreatment data showed acceptable accuracy (AUC: 0.82; 95% CI: 0.76-0.89).

Conclusions: The developed multivariable risk prediction models can accurately predict cardiotoxicity and support effective surveillance in patients with breast cancer receiving chemotherapy.

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乳腺癌患者心脏毒性的风险预测模型：多中心前瞻性CHECK心脏- bc研究

背景：早期发现和治疗心脏毒性对于减少心脏事件至关重要。然而，对于接受化疗的乳腺癌患者的心脏毒性，目前还缺乏可靠的预测模型。目的：在本研究中，我们旨在建立乳腺癌化疗患者的风险预测模型并建立有效的心脏毒性监测。方法：在2017年8月至2020年3月期间，在25家参与机构对计划进行新辅助和/或辅助化疗的乳腺癌患者进行前瞻性筛查。心脏毒性定义为左心室射血分数从基线降低10%至某值。结果：该研究包括559例chemotherapy-naïve女性患者。在366天的中位随访期间（Q1-Q3: 365-367天），559例患者中有46例（8.2%）观察到心脏毒性。CHECK HEART（综合心脏成像评估乳腺癌患者化疗相关心脏损伤）评分包括6个变量：心率、左心室整体纵向应变、左心室收缩末期和舒张末期直径、右心室分数面积变化以及蒽环类药物和曲妥珠单抗的治疗。基于预处理数据的12个月受试者工作特征曲线下的时间依赖面积（AUC）显示出可接受的准确性（AUC: 0.82; 95% CI: 0.76-0.89）。结论：建立的多变量风险预测模型可以准确预测乳腺癌化疗患者的心脏毒性，并支持有效的监测。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JACC. Asia Cardiology and Cardiovascular Medicine

CiteScore

4.00

自引率

0.00%

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