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Cardiotoxicity, defined by declines in left ventricular ejection fraction (LVEF) and symptomatic heart failure (HF), is a significant complication of commonly used treatments for breast cancer patients. Although recent studies have resulted in a better understanding of the changes in LVEF with anthracyclines and trastuzumab, there are numerous unanswered questions pertaining to an individual patient's response to potentially cardiotoxic cancer therapy. For example, are there distinct patterns of LVEF change with anthracyclines and/or trastuzumab? What is the significance of modest LVEF declines that do not meet the standard criteria for cardiac dysfunction (i.e., LVEF decline of ≥10% to <50%)? Techniques such as latent class analysis have been used to understand how changes in cardiovascular risk factors inform the development of overt cardiovascular disease and to define new phenotypes in heterogeneous disease states.

We sought to determine if we could apply such methods to breast cancer patients treated with anthracyclines and/or trastuzumab to understand the potential distinct cardiovascular responses to these cardiotoxic therapies.

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