Early detection of broken hearts in cancer: Bevacizumab and Sunitinib mediated cardiotoxicity
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Background: Although Bevacizumab (BVZ) and Sunitinib (SNT) prolong survival in cancer patients, an unanticipated side-effect is cardiotoxicity. Early indices of left ventricular (LV) systolic dysfunction would be useful to address the cardiac safety of anti-cancer drugs. Objective: Whether cardiac biomarkers, tissue velocity imaging (TVI), and/or strain rate (SR) can detect early cardiac dysfunction. Methods: A total of 95 C57Bl/6 mice received one of the following drug regimens: i) 0.9% saline; ii) BVZ; or iii) SNT and followed for 14 days. Serial blood pressure, high sensitivity troponin I (hsTnI), and echocardiography were performed. Results: BVZ- and SNT-treated mice demonstrated an increase in mean arterial blood pressure, hsTnI, cardiac apoptosis, and loss of cell integrity. TVI and SR values confirmed early LV systolic dysfunction at day 8, compared to conventional LVEF at day 13. Conclusions: Novel imaging techniques can detect early LV systolic dysfunction in a model of drug-mediated cardiomyopathy.