The Role of Selvester Score on 12-Lead ECG in Determination of Left Ventricular Systolic Dysfunction Among Patients Receiving Trastuzumab Therapy

Yılmaz, Mustafa; Akgun, Arzu Neslihan; MUDERRİSOGLU, IBRAHIM HALDUN; Yilmaz, Kerem Can; çiftci, orçun; Oğuz, Arzu; Karacaglar, Emir

doi:DOI: 10.5152/EurJTher.2019.18061

The Role of Selvester Score on 12-Lead ECG in Determination of Left Ventricular Systolic Dysfunction Among Patients Receiving Trastuzumab Therapy

Orçun ÇİFTÇİ, (Başkent Üniversitesi Tıp Fakültesi Kardiyoloji Anabilim Dalı, Ankara, Türkiye)

Kerem Can YILMAZ, (Başkent Üniversitesi Tıp Fakültesi Kardiyoloji Anabilim Dalı, Ankara, Türkiye)

Emir KARAÇAĞLAR, (Başkent Üniversitesi Tıp Fakültesi Kardiyoloji Anabilim Dalı, Ankara, Türkiye)

Arzu Neslihan AKGÜN, (Başkent Üniversitesi Tıp Fakültesi Kardiyoloji Anabilim Dalı, Ankara, Türkiye)

Mustafa YILMAZ, (Başkent Üniversitesi Tıp Fakültesi Kardiyoloji Anabilim Dalı, Ankara, Türkiye)

Arzu OĞUZ, (Başkent Üniversitesi, Tıp Fakültesi, Tıbbi Onkoloji Anabilim Dalı, İç Hastalıkları Bölümü, Ankara, Türkiye)

Haldun MÜDERRİSOĞLU (Başkent Üniversitesi Tıp Fakültesi Kardiyoloji Anabilim Dalı, Ankara, Türkiye)

European Journal of Therapeutics

2 2

Yıl: 2019 Cilt: 25 Sayı: 1 Sayfa Aralığı: 69 - 75 Metin Dili: İngilizce DOI: DOI: 10.5152/EurJTher.2019.18061 İndeks Tarihi: 26-11-2020

The Role of Selvester Score on 12-Lead ECG in Determination of Left Ventricular Systolic Dysfunction Among Patients Receiving Trastuzumab Therapy

Öz:

Objective: Breast cancer is the most common cancer in women. Trastuzumab is an effective breast cancer agent. The most significant side effect of trastuzumab is left ventricular systolic dysfunction. Selvester score calculated from 12-lead electrocardiography (ECG) has a proven accuracy in predicting left ventricular infarct area and scar volume. We aimed to determine its role in detection of left ventricular systolic dysfunction among trastuzumab-treated breast cancer patients. Methods: A total of 60 trastuzumab-treated patients were retrospectively included. The patients were grouped into two groups with trastuzumab-induced left ventricular systolic dysfunction (left ventricular ejection fraction (LVEF) <55%) (Group 1) and without (Group 2). The left ventricular systolic dysfunction group was divided into two subgroups: LVEF <50% and (Group 1a) and LVEF 50–54% (Group 1b). The Selvester score was compared between Group 1 and Group 2, and between Group 1a, Group 1b, and Group 2. The predictive role of Selvester score in trastuzumab-induced left ventricular systolic dysfunction was determined with univariate and multivariate analysis. Results: The mean age of the patients was 56.7±13.7 years. Twenty (21.1%) patients had trastuzumab-induced left ventricular systolic dysfunction. The Selvester score was similar between Group 1 and Group 2. Group 1a had a significantly greater Selvester score compared to Group 1b and Group 2 (p<0.05); however, Group 1b and Group 2 had similar Selvester scores (p>0.05). The Selvester score was significantly correlated with left ventricular systolic dysfunction in univariate analysis (r=0.189, p<0.05) but not in multivariate analysis. Conclusion: Selvester score may be useful especially for detecting severe trastuzumab-induced left ventricular systolic dysfunction.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin 2015; 65: 87-108.
Untch M, Ditsch N, Hermelink K. Immunotherapy: New options in breast cancer treatment. Expert Rev Anticancer Ther 2003; 3: 403-8.
Sengupta PP, Northfelt DW, Gentile F, Zamorano JL, Khandheria BK. Trastuzumab-induced cardiotoxicity: Heart failure at the crossroads. Mayo Clin Proc 2008; 83: 197-203.
Marty M, Cognetti F, Maraninchi D, Snyder R, Mauriac L, Tubiana-Hulin M, et al. Randomized phase II trial of the efficacy and safety of trastuzumab combined with docetaxel in patients with human epidermal growth factor receptor 2-positive metastatic breast cancer administered as first-line treatment: the M77001 Study Group. J Clin Oncol 2005; 23: 4265274.
Piccart-Gebhart MJ, Procter M, Leyland-Jones B, Goldhirsch A, Untch M, Smith I, et al. Trastuzumab after adjuvant chemotherapy in HER-2 positive breast cancer. N Engl J Med 2005; 353: 1659-72.
Romond EH, Perez EA, Bryant J, Suman VJ, Geyer CE Jr, Davidson NE, et al. Trastuzumab plus adjuvant chemotherapy for operable HER2-positive breast cancer. N Engl J Med 2005; 353: 1673-84.
Vogel CL, Cobleigh MA, Tripathy D, Gutheil JC, Harris LN, Fehrenbacher L et al. Efficacy and safety of trastuzumab as a single agent in first-line treatment of HER2-overexpressing metastatic breast cancer. J Clin Oncol 2002; 20: 719-26.
Seidman A, Hudis C, Pierri MK, Shak S, Paton V, Ashby M, et al. Cardiac dysfunction in the trastuzumab clinical trials experience. J Clin Oncol 2002; 20: 1215-21.
Keefe DL. Trastuzumab-associated cardiotoxicity. Cancer 2002; 95: 1592-600.
10. Romond EH, Jeong JH, Rastogi P, Swain SM, Geyer CE Jr, Ewer MS, et al. Seven-year follow-up assessment of cardiac function in NSABP B-31, a randomized trial comparing doxorubicin and cyclophosphamide followed by paclitaxel (ACP) with ACP plus trastuzumab as adjuvant therapy for patients with node-positive, human epidermal growth factor receptor 2-positive breast cancer. J Clin Oncol 2012; 30: 3792-9.
11. Slamon DJ, Leyland-Jones B, Shak S, Fuchs H, Paton V, Bajamonde A, et al. Use of chemotherapy plus a monoclonal antibody against HER2 for metastatic breast cancer that overexpresses HER2. N Engl J Med 2001; 344: 783-92.
12. Yeh ET, Bickford CL. Cardiovascular complications of cancer therapy: incidence, pathogenesis, diagnosis, and management. J Am Coll Cardiol 2009; 53: 2231-47.
13. Vasu S, Hundley WG. Understanding cardiovascular injury after treatment for cancer: an overview of current uses and future directions of cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2013; 15: 66.
14. Selvester RH, Wagner GS, Hindman NB. The Selvester QRS scoring system for estimating myocardial infarct size. The development and application of the system. Arch Intern Med 1985; 145: 1877-81.
15. Wagner GS, Freye CJ, Palmeri ST, Roark SF, Stack NC, Ideker RE, et al. Evaluation of a QRS scoring system for estimating myocardial infarct size. I. Specificity and observer agreement. Circulation 1982; 65: 342-7.
16. Hindman NB, Schocken DD, Widmann M, Anderson WD, White RD, Leggett S, et al. Evaluation of a QRS scoring system for estimating myocardial infarct size. V. Specificity and method of application of the complete system. Am J Cardiol 1985; 55: 1485-90.
17. Carey MG, Luisi AJ, Baldwa S, Al-Zaiti S, Veneziano MJ, deKemp RA, et al. The Selvester QRS Score is more accurate than Q waves and fragmented QRS complexes using the Mason-Likar configuration in estimating infarct volume in patients with ischemic cardiomyopathy. J Electrocardiol 2010; 43: 318-25.
18. Strauss DG, Selvester RH, Lima JA, Arheden H, Miller JM, Gerstenblith G, et al. ECG quantification of myocardial scar in cardiomyopathy patients with or without conduction defects: correlation with cardiac magnetic resonance and arrhythmogenesis. Circ Arrhythm Electrophysiol 2008; 1: 327-36.
19. Strauss DG, Selvester RH. The QRS complex--a biomarker that “images” the heart: QRS scores to quantify myocardial scar in the presence of normal and abnormal ventricular conduction. J Electrocardiol 2009; 42: 85-96.
20. Strauss DG, Cardoso S, Lima JA, Rochitte CE, Wu KC. ECG scar quantification correlates with cardiac magnetic resonance scar size and prognostic factors in Chagas’ disease. Heart 2011; 97: 357-61.
21. Tjandrawidjaja MC, Fu Y, Westerhout CM, Wagner GS, Granger CB, Armstrong PW. Usefulness of the QRS score as a strong prognostic marker in patients discharged after undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction. Am J Cardiol 2010; 106: 630-4.
22. Engblom H, Wagner GS, Setser RM, Selvester RH, Billgren T, Kasper JM, et al. Quantitative clinical assessment of chronic anterior myocardial infarction with delayedenhancement magnetic resonance imaging and QRS scoring. Am Heart J 2003; 146: 359-66.
23. Spector NL, Blackwell K. Understanding the mechanisms behind trastuzumab therapy for human epidermal growth factor receptor 2-positive breast cancer. J Clin Oncol 2009; 27: 5838-47.
24. Pondé NF, Lambertini M, de Azambuja E. Twenty years of anti-HER2 therapy-associated cardiotoxicity. ESMO Open 2016; 1: e000073.
25. Grazette LP, Boecker W, Matsui T, Semigran M, Force TL, Hajjar RJ, et al. Inhibition of ErbB2 causes mitochondrial dysfunction in cardiomyocytes: implications for herceptin-induced cardiomyopathy. J Am Coll Cardiol 2004; 44: 2231-8.
26. Kuramochi Y, Guo X, Sawyer DB. Neuregulin activates erbB2-dependent src/FAK signaling and cytoskeletal remodeling in isolated adult rat cardiac myocytes. J Mol Cell Cardiol 2006; 41: 228-35.
27. ElZarrad MK, Mukhopadhyay P, Mohan N, Hao E, Dokmanovic M, Hirsch DS, et al. Trastuzumab alters the expression of genes essential for cardiac function and induces ultrastructural changes of cardiomyocytes in mice. PLoS One 2013; 8: e79543.
28. Walker JR, Sharma A, Lytwyn M, Bohonis S, Thliveris J, Singal PK, et al. The cardioprotective role of probucol against anthracycline and trastuzumab-mediated cardiotoxicity. J Am Soc Echocardiogr 2011; 24: 699-705.
29. Walker J, Bhullar N, Fallah-Rad N, Lytwyn M, Golian M, Fang T, et al. Role of three-dimensional echocardiography in breast cancer: comparison with two-dimensional echocardiography, multiple-gated acquisition scans, and cardiac magnetic resonance imaging. J Clin Oncol 2010 20; 28: 3429-36.
30. Fallah-Rad N, Walker JR, Wassef A, Lytwyn M, Bohonis S, Fang T, et al. The utility of cardiac biomarkers, tissue velocity and strain imaging, and cardiac magnetic resonance imaging in predicting early left ventricular dysfunction in patients with human epidermal growth factor receptor II-positive breast cancer treated with adjuvant trastuzumab therapy. J Am Coll Cardiol 2011; 57: 2263-70.

APA	çiftci o, Yilmaz K, Karacaglar E, Akgun A, Yılmaz M, Oğuz A, MUDERRİSOGLU I (2019). The Role of Selvester Score on 12-Lead ECG in Determination of Left Ventricular Systolic Dysfunction Among Patients Receiving Trastuzumab Therapy. , 69 - 75. DOI: 10.5152/EurJTher.2019.18061
Chicago	çiftci orçun,Yilmaz Kerem Can,Karacaglar Emir,Akgun Arzu Neslihan,Yılmaz Mustafa,Oğuz Arzu,MUDERRİSOGLU IBRAHIM HALDUN The Role of Selvester Score on 12-Lead ECG in Determination of Left Ventricular Systolic Dysfunction Among Patients Receiving Trastuzumab Therapy. (2019): 69 - 75. DOI: 10.5152/EurJTher.2019.18061
MLA	çiftci orçun,Yilmaz Kerem Can,Karacaglar Emir,Akgun Arzu Neslihan,Yılmaz Mustafa,Oğuz Arzu,MUDERRİSOGLU IBRAHIM HALDUN The Role of Selvester Score on 12-Lead ECG in Determination of Left Ventricular Systolic Dysfunction Among Patients Receiving Trastuzumab Therapy. , 2019, ss.69 - 75. DOI: 10.5152/EurJTher.2019.18061
AMA	çiftci o,Yilmaz K,Karacaglar E,Akgun A,Yılmaz M,Oğuz A,MUDERRİSOGLU I The Role of Selvester Score on 12-Lead ECG in Determination of Left Ventricular Systolic Dysfunction Among Patients Receiving Trastuzumab Therapy. . 2019; 69 - 75. DOI: 10.5152/EurJTher.2019.18061
Vancouver	çiftci o,Yilmaz K,Karacaglar E,Akgun A,Yılmaz M,Oğuz A,MUDERRİSOGLU I The Role of Selvester Score on 12-Lead ECG in Determination of Left Ventricular Systolic Dysfunction Among Patients Receiving Trastuzumab Therapy. . 2019; 69 - 75. DOI: 10.5152/EurJTher.2019.18061
IEEE	çiftci o,Yilmaz K,Karacaglar E,Akgun A,Yılmaz M,Oğuz A,MUDERRİSOGLU I "The Role of Selvester Score on 12-Lead ECG in Determination of Left Ventricular Systolic Dysfunction Among Patients Receiving Trastuzumab Therapy." , ss.69 - 75, 2019. DOI: 10.5152/EurJTher.2019.18061
ISNAD	çiftci, orçun vd. "The Role of Selvester Score on 12-Lead ECG in Determination of Left Ventricular Systolic Dysfunction Among Patients Receiving Trastuzumab Therapy". (2019), 69-75. https://doi.org/DOI: 10.5152/EurJTher.2019.18061

APA	çiftci o, Yilmaz K, Karacaglar E, Akgun A, Yılmaz M, Oğuz A, MUDERRİSOGLU I (2019). The Role of Selvester Score on 12-Lead ECG in Determination of Left Ventricular Systolic Dysfunction Among Patients Receiving Trastuzumab Therapy. European Journal of Therapeutics, 25(1), 69 - 75. DOI: 10.5152/EurJTher.2019.18061
Chicago	çiftci orçun,Yilmaz Kerem Can,Karacaglar Emir,Akgun Arzu Neslihan,Yılmaz Mustafa,Oğuz Arzu,MUDERRİSOGLU IBRAHIM HALDUN The Role of Selvester Score on 12-Lead ECG in Determination of Left Ventricular Systolic Dysfunction Among Patients Receiving Trastuzumab Therapy. European Journal of Therapeutics 25, no.1 (2019): 69 - 75. DOI: 10.5152/EurJTher.2019.18061
MLA	çiftci orçun,Yilmaz Kerem Can,Karacaglar Emir,Akgun Arzu Neslihan,Yılmaz Mustafa,Oğuz Arzu,MUDERRİSOGLU IBRAHIM HALDUN The Role of Selvester Score on 12-Lead ECG in Determination of Left Ventricular Systolic Dysfunction Among Patients Receiving Trastuzumab Therapy. European Journal of Therapeutics, vol.25, no.1, 2019, ss.69 - 75. DOI: 10.5152/EurJTher.2019.18061
AMA	çiftci o,Yilmaz K,Karacaglar E,Akgun A,Yılmaz M,Oğuz A,MUDERRİSOGLU I The Role of Selvester Score on 12-Lead ECG in Determination of Left Ventricular Systolic Dysfunction Among Patients Receiving Trastuzumab Therapy. European Journal of Therapeutics. 2019; 25(1): 69 - 75. DOI: 10.5152/EurJTher.2019.18061
Vancouver	çiftci o,Yilmaz K,Karacaglar E,Akgun A,Yılmaz M,Oğuz A,MUDERRİSOGLU I The Role of Selvester Score on 12-Lead ECG in Determination of Left Ventricular Systolic Dysfunction Among Patients Receiving Trastuzumab Therapy. European Journal of Therapeutics. 2019; 25(1): 69 - 75. DOI: 10.5152/EurJTher.2019.18061
IEEE	çiftci o,Yilmaz K,Karacaglar E,Akgun A,Yılmaz M,Oğuz A,MUDERRİSOGLU I "The Role of Selvester Score on 12-Lead ECG in Determination of Left Ventricular Systolic Dysfunction Among Patients Receiving Trastuzumab Therapy." European Journal of Therapeutics, 25, ss.69 - 75, 2019. DOI: 10.5152/EurJTher.2019.18061
ISNAD	çiftci, orçun vd. "The Role of Selvester Score on 12-Lead ECG in Determination of Left Ventricular Systolic Dysfunction Among Patients Receiving Trastuzumab Therapy". European Journal of Therapeutics 25/1 (2019), 69-75. https://doi.org/DOI: 10.5152/EurJTher.2019.18061