|
2DE
|
CMR-LVEF at 6 months after start trastuzumab
|
Change in CMR-LVEF at 6 months after start trastuzumab
|
Cardiotoxicitya
|
|---|
|
Univariable analysis
|
Multivariable analysis
|
Univariable
|
Univariable
|
|---|
|
Mean difference (95% CI)
|
P-value
|
R2
|
Mean difference (95% CI)
|
P-value
|
R2
|
Mean difference (95% CI)
|
P-value
|
R2
|
Median in patients with CTOX [IQR]
|
median in patients without CTOX [IQR]
|
OR (95% CI)
|
P-value
|
R2
|
|---|
|
Before start anthracycline
|
|
LVEF, %
|
0.42 (−0.02, 0.85)
|
0.058
|
0.11
| | | |
0.23 (− 0.22, 0.68)
|
0.297
|
0.04
|
63.0 [58.8, 65.5]
|
69.0 [64.0, 77.0]
|
0.77 (0.61, 0.97)
|
0.027
|
0.26
|
|
ST-GLS, %
|
0.24 (−0.83, 1.31)
|
0.649
|
0.01
| | | |
0.42 (− 0.64, 1.49)
|
0.422
|
0.02
|
−17.0 [− 18.5, − 14.6]
|
− 16.0 [− 18.5, − 13.0]
|
0.81 (0.59, 1.11)
|
0.377
|
0.05
|
|
ST-GRS, %
|
0.11 (− 0.11, 0.33)
|
0.322
|
0.01
| | | |
− 0.03 (− 0.26, 0.19)
|
0.767
|
0.09
|
26.5 [15.2, 36.0]
|
27.2 [13.4, 36.5]
|
0.99 (0.93, 1.05)
|
0.721
|
0.01
|
|
Change during anthracycline
|
|
LVEF, %
|
0.11 (− 0.29, 0.51)
|
0.570
|
0.01
|
0.03 (− 0.39, 0.45)
|
0.879
|
0.07
|
−0.05 (− 0.45, 0.35)
|
0.790
|
0.01
|
−2.0 [−7.0, 1.0]
|
−7.0 [− 13.0, 0.0]
|
1.07 (0.95, 1.21)
|
0.250
|
0.05
|
|
ST-GLS, %
|
− 0.86 (− 2.02, 0.30)
|
0.142
|
0.07
|
− 0.83 (− 2.08, 0.42)
|
0.186
| |
−0.86 (−2.03, 0.30)
|
0.141
|
0.07
|
4.4 [0.0, 6.0]
|
0.2 [−0.1, 2.0]
|
1.39 (0.99, 1.95)
|
0.058
|
0.12
|
|
ST-GRS, %
|
−0.04 (− 0.39, 0.31)
|
0.829
|
0.00
| | | |
0.08 (− 0.27, 0.43)
|
0.631
|
0.01
|
−4.2 [− 14.0, 2.3]
|
−0.9 [− 12.2, 4.3]
|
1.00 (0.92, 1.10)
|
0.942
|
0.00
|
|
Before start trastuzumab
|
|
LVEF, %
|
0.85 (0.42, 1.27)
|
< 0.001
|
0.30
|
0.87 (0.41, 1.34)
|
< 0.001
|
0.30
|
0.32 (− 0.16, 0.80)
|
0.189
|
0.05
|
60.0 [57.3, 62.8]
|
63.0 [60.0, 66.0]
|
0.88 (0.75, 1.02)
|
0.080
|
0.13
|
|
ST-GLS, %
|
− 0.42 (− 1.31, 0.46)
|
0.337
|
0.03
|
0.14 (− 0.68, 0.95)
|
0.738
| |
−0.28 (− 1.14, 0.58)
|
0.519
|
0.01
|
−13.7 [− 16.9, − 11.2]
|
− 15.0 [− 17.3, − 12.2]
|
1.13 (0.87, 1.46)
|
0.365
|
0.03
|
|
ST-GRS, %
|
0.08 (− 0.13, 0.28)
|
0.464
|
0.07
| | | |
−0.02 (− 0.22, 0.18)
|
0.831
|
0.00
|
31.4 [4.5, 42.1]
|
22.4 [8.5, 35.5]
|
0.99 (0.94, 1.05)
|
0.830
|
0.00
|
|
3 Months after start trastuzumab
|
|
LVEF, %
|
0.59 (0.30, 0.88)
|
< 0.001
|
0.32
|
0.56 (0.24, 0.87)
|
0.001
|
0.35
|
0.29 (− 0.04, 0.61)
|
0.080
|
0.08
|
55.0 [43.4, 62.8]
|
60.0 [57.0, 63.0]
|
0.85 (0.74, 0.98)
|
0.029
|
0.28
|
|
ST-GLS, %
|
− 1.14 (− 2.07, − 0.19)
|
0.018
|
0.10
|
− 0.46 (− 1.34, 0.41)
|
0.288
| |
−0.62 (− 1.54, 0.30)
|
0.179
|
0.05
|
−11.6 [− 15.3, − 9.4]
|
− 14.1 [− 16.6, − 11.7]
|
1.36 (0.94, 1.84)
|
0.073
|
0.13
|
|
ST-GRS, %
|
0.04 (− 0.23, 0.31)
|
0.751
|
0.00
| | | |
−0.15 (− 0.40, 0.10)
|
0.237
|
0.04
|
28.1 [8.5, 35.3]
|
21.2 [12.1, 32.0]
|
1.03 (0.95, 1.11)
|
0.532
|
0.02
|
|
Change at 3 months after start trastuzumab
|
|
LVEF, %
|
0.30 (−0.11, − 0.71)
|
0.144
|
0.06
|
0.33 (− 0.06, 0.72)
|
0.094
|
0.22
|
0.21 (−0.19, 0.61)
|
0.292
|
0.03
|
−11.0 [− 19.0, − 2.0]
|
− 4.0 [− 7.0, 0.0]
|
0.90 (0.80, 1.01)
|
0.079
|
0.09
|
|
ST-GLS, %
|
− 1.17 (− 2.14, − 0.20)
|
0.019
|
0.14
|
−1.20 (− 2.16, − 0.24)
|
0.016
| |
−1.10 (−2.02, − 0.18)
|
0.021
|
0.14
|
5.2 [2.8, 7.0]
|
1.7 [−0.2, 3.0]
|
1.81 (1.11, 2.93)
|
0.016
|
0.34
|
|
ST-GRS, %
|
− 0.17 (− 0.57, 0.23)
|
0.386
|
0.03
| | | |
−0.12 (− 0.52, 0.27)
|
0.521
|
0.02
|
−0.7 [− 10.0, 2.0]
|
−3.0 [− 9.7, 1.4]
|
1.03 (0.92, 1.15)
|
0.610
|
0.01
|
- Abbreviations: 2DE two-dimensional echocardiography, CMR cardiac magnetic resonance imaging, GLS global longitudinal strain, GRS global radial strain, LVEF left ventricular ejection fraction, OR odds ratio, R2 explained variance, ST speckle tracking, CTOX cardiotoxicity
- aCardiotoxicity was defined as LVEF < 45% during the 6 months follow-up and/or an absolute LVEF decline of > 10% relative to the measurement at study start and measured with CMR
