Myocardial Function in Premenopausal Women Treated With Ovarian Function Suppression and an Aromatase Inhibitor.

Jordan, Jennifer H

D'Agostino, Ralph B

Ansley, Katherine

Douglas, Emily

Melin, Susan

Sorscher, Steven

Vasu, Sujethra

Park, Sung

Kotak, Anuj

Romitti, Paul A

O'Connell, Nathanial S

Hundley, William G

Thomas, Alexandra

2024-02-01T14:27:00Z

2024-02-01T14:27:00Z

2021-08

Premenopausal women with high-risk hormone receptor (HR)-positive breast cancer often receive ovarian function suppression (OFS) with aromatase inhibitor therapy; however, abrupt menopause induction, together with further decrements in estrogen exposure through aromatase inhibition, may affect cardiovascular microcirculatory function. We examined adenosine-induced changes in left ventricular (LV) myocardial T1, a potential subclinical marker of LV microcirculatory function in premenopausal women undergoing treatment for breast cancer. Twenty-one premenopausal women (14 with HR-positive breast cancer receiving OFS with an aromatase inhibitor and 7 comparator women with triple-negative breast cancer [TNBC] who had completed primary systemic therapy) underwent serial resting and adenosine cardiovascular magnetic resonance imaging measurements of LV myocardial T1 and LV volumes, mass, and ejection fraction. All statistical tests were 2-sided. After a median of 4.0 months (range = 3.1-5.7 months), the stress to resting ratio of LV myocardial T1 declined in women with HR-positive breast cancer (-1.3%, 95% confidence interval [CI] = -3.4% to 0.7%) relative to those with TNBC (3.2%, 95% CI = -1.2% to 7.6%, P = .02). After accounting for age, LV stroke volume, LV ejection fraction, diastolic blood pressure, and breast cancer subtype women with HR-positive breast cancer experienced a blunted T1 response after adenosine relative to women with TNBC (difference = -4.7%, 95% CI = -7.3% to -2.1%, Pdifference = .002). Over the brief interval examined, women with HR-positive breast cancer receiving OFS with an aromatase inhibitor experienced reductions in adenosine-associated changes in LV myocardial T1 relative to women who received nonhormonal therapy for TNBC. These findings suggest a possible adverse impact on LV myocardial microcirculatory function in premenopausal women with breast cancer receiving hormone deprivation therapy.

pkab071

2515-5091

2515-5091

https://hdl.handle.net/10161/29967

eng

Oxford University Press (OUP)

JNCI cancer spectrum

10.1093/jncics/pkab071

https://creativecommons.org/licenses/by-nc/4.0

Ovary

Microcirculation

Humans

Breast Neoplasms

Receptors, Estrogen

Adenosine

Aromatase Inhibitors

Magnetic Resonance Imaging

Stroke Volume

Body Mass Index

Pilot Projects

Age Factors

Premenopause

Ventricular Function, Left

Adult

Middle Aged

Female

Triple Negative Breast Neoplasms

Cardiotoxicity

Myocardial Function in Premenopausal Women Treated With Ovarian Function Suppression and an Aromatase Inhibitor.

Journal article

Thomas, Alexandra|0000-0001-9022-2229

4

Duke

School of Medicine

Clinical Science Departments

Medicine

Medicine, Medical Oncology

Published

5