Despite great progress in anticancer therapies, these are often associated with toxicity for the heart that may necessitate pausing or discontinuing the chemotherapy or may lead to subsequent heart failure. Detection of chemotherapy-related cardiotoxicity is currently based on a decrease in global heart function, most commonly assessed by echocardiography. However, current methods may not detect cardiotoxicity until an advanced stage, when damage may be irreversible. Strain imaging is a more sensitive method to detect cardiotoxicity but measurements may vary depending on the equipment used, may not be possible in many patients and have not been proven to benefit patients.
1) To perform standardization of strain imaging among different equipment using a dynamic cardiac simulator
2) To test the applicability and accuracy of new imaging tools to detect cardiotoxicity, especially when strain imaging is not feasible
3) To demonstrate the clinical benefit of early detection of cardiotoxicity with these techniques
The first project will standardize currently available strain algorithms according to a gold standard simulator, followed by validation in patients.
The second project will demonstrate that new measurements of heart function, based on blood flow, are as good as strain imaging for the detection of cardiotoxicity.
Finally, the third project will study women with breast cancer who are scheduled to receive chemotherapy. Conventional assessment of heart function will be compared to strain imaging and the newer measurements in their power to detect cardiotoxicity and guide medical management to preserve heart function.
The strengths of this research proposal are to rigorously standardize, increase applicability and confirm the clinical benefits of a strategy that detects cardiotoxicity as early as possible. This is of critical importance since accurate and reliable measurements of heart function are essential to enable future research programs to test specific protective or supportive strategies.