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Table 2 Association between measures obtained by 2DE-ST before anthracycline, before trastuzumab and after 3 months trastuzumab, and CMR-LVEF at 6 months

From: 2D-echocardiography vs cardiac MRI strain: a prospective cohort study in patients with HER2-positive breast cancer undergoing trastuzumab

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
  1. 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
  2. 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