Inclusion and Exclusion Criteria: Myocardial Structural, Functional, and Metabolic Changes in Women Undergoing Breast Cancer Chemotherapy

Inclusion Criteria

  • Women from diverse racial/ethnic groups
  • Competent to give informed consent
  • Diagnosed with Stage I, II, or III (left or right) sided breast cancer
  • Systemic therapy recommended (anthracycline-based chemotherapy and/or adjuvant trastuzumab), and with or without therapeutic irradiation

Exclusion Criteria

  • Known cardiomyopathy prior to chemotherapy: infiltrative, hypertensive, idiopathic, hypertrophic, or dilated
  • LV dysfunction (less than 55%), acute coronary syndrome (defined by WHO), cardiogenic shock or requiring inotropic or intra-aortic balloon support
  • Planned percutaneous coronary intervention or CABG or established obstructive CAD with ischemia eligible for revascularization, acute MI
  • Prior non-cardiac illness with an estimated life expectancy < 4 years
  • Unable to give informed consent
  • Allergy or contra-indication to CMRI testing, including renal failure, claustrophobia, uncontrolled moderate hypertension (sitting blood pressure > 160/95 mmHg with measurements recorded on at least 2 occasions)
  • Conditions likely to influence outcomes: Severe lung, renal (creatinine > 1.8 or CrCl ≤ 50 ml/min) or hepatic disease
  • Surgically uncorrected significant congenital or valvular heart disease and other disease likely to be fatal or require frequent hospitalization within the next six months
  • Unwilling to complete follow-up evaluation including repeat testing
  • Aortic stenosis (valve area < 1.5 cm)  
  • Women who are pregnant
  • Women with claustrophobia and metallic parts in body prohibiting MRI and MRS
  • Irregular heart rhythm
  • Prior gadolinium contrast reaction
  • Allergy to animal dandruff

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