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NCT03862131 · OUTCOME

Specificity of MyoStrain® and CMR Standard Measurements (LV End Diastolic Volume Index, LV End Systolic Volume Index, LV Stroke Volume Index and Left Ventricular Ejection Fraction) to Detect Myocardial Dysfunction During Cancer Treatment

PROactive Evaluation of Function to Avoid CardioToxicity · Source last updated 2025-07-29

Results reported by the registry submitting party. Population, time horizon, units and missing values must be read together.

Measure
NUMBER
Unit
percent specificity
Interval / dispersion
95% Confidence Interval
Time frame
Through 36 months

What was measured

Specificity is defined as the number of true negatives divided by the number of true negatives + number of false positives. * Myocardial dysfunction was defined as the occurrence of either clinical or subclinical cardiotoxicity. * Clinical cardiotoxicity was defined as an absolute change in LVEF \> 10% from baseline to below 53% combined with heart failure symptoms or elevation in NT pro BNP to above 199 pg/mL. * In patients with LVEF \< 53% at baseline, clinical cardiotoxicity was defined by a symptomatic drop in LVEF \> 10% or a HF hospitalization. * Subclinical CTX was defined as an asymptomatic patient with a greater than 10% decrease in LVEF, worsening GLS more than 15% from baseline, or new elevation in NT pro BNP \> 199 pg/mL

Groups in this outcome

MyoStrain® Unblinded Treatment Arm

* After consenting to the PROACT study, patients will undergo a baseline MRI to determine their risk stratification for the study. This baseline MyoStrain® MRI must demonstrate 2 or more segments measuring \>-10% or 9 or more segments \>-17% for entrance into the study as the Higher Risk Group * The unblinded treatment arm will enhance patient management by augmenting standard of care with serial MyoStrain® monitoring of the impact of cancer therapy on myocardial function. * Higher Risk unblinded patients will continue to undergo MyoStrain® MRI testing, regardless of study arm, at 1 month (+1 week), 3 months (+ 1 week), 6 months (+1 week), 12 months (+ 30 days), 24 months (+30 days), and 36 months (+30 days) after the baseline visit. * In addition to the MyoStrain® testing, patients will also be asked to complete a brief patient satisfaction questionnaire at each PROACT time point.

MyoStrain® Blinded Control Arm

* After consenting to the PROACT study, patients will undergo a baseline MRI to determine their risk stratification for the study. This baseline MyoStrain® MRI must demonstrate 2 or more segments measuring \>-10% or 9 or more segments \>-17% for entrance into the study as the Higher Risk group * The blinded control arm will provide investigators with LVEF and LVEDV/LVESV measurements, which are clinical, in conjunction with standard of care * Higher Risk blinded patients will continue to undergo MyoStrain® MRI testing, regardless of study arm, at 1 month (+1 week), 3 months (+ 1 week), 6 months (+1 week), 12 months (+ 30 days), 24 months (+30 days), and 36 months (+30 days) after the baseline visit. * In addition to the MyoStrain® testing, patients will also be asked to complete a brief patient satisfaction questionnaire at each PROACT time point.

Combined MyoStrain® Control Arm and Treatment Arm

* After consenting to the PROACT study, patients will undergo a baseline MRI to determine their risk stratification for the study. This baseline MyoStrain® MRI must demonstrate 2 or more segments measuring \>-10% or 9 or more segments \>-17% for entrance into the study as the Higher Risk Group. * After meeting eligibility criteria, patients will be further randomized to an unblinded arm (MyoStrain® measured and available to the treatment team) and a blinded arm (MyoStrain® measured but not available to the treatment team). This randomization will aid in an exploratory aim of testing the feasibility of MyoStrain® to guide cardioprotective therapy in the unblinded vs blinded arms. However, as all patients will have MyoStrain® measured, all patients (both treatment arms) will be combined for testing the primary outcome measure.

Group identifiers and denominators belong to this outcome only. They may differ in another outcome or in safety reporting.

Analysis denominator · Participants

GroupSource count
MyoStrain® Unblinded Treatment Arm25
MyoStrain® Blinded Control Arm18
Combined MyoStrain® Control Arm and Treatment Arm43

Reported measurements

MyoStrain®
Values in percent specificity · Interval/dispersion: 95% Confidence Interval
GroupValueSpreadLowerUpperComment
MyoStrain® Unblinded Treatment Arm77.9Not reported70.585.2Not reported
MyoStrain® Blinded Control Arm88.4Not reported81.695.1Not reported
Combined MyoStrain® Control Arm and Treatment Arm73.6Not reported67.679.6Not reported
CMR LVEF
Values in percent specificity · Interval/dispersion: 95% Confidence Interval
GroupValueSpreadLowerUpperComment
MyoStrain® Unblinded Treatment Arm95.0Not reported91.298.9Not reported
MyoStrain® Blinded Control Arm90.5Not reported84.296.8Not reported
Combined MyoStrain® Control Arm and Treatment Arm86.3Not reported81.691.0Not reported
CMR left ventricular end-diastolic indexed (LVEDVI)
Values in percent specificity · Interval/dispersion: 95% Confidence Interval
GroupValueSpreadLowerUpperComment
MyoStrain® Unblinded Treatment Arm75.2Not reported67.582.9Not reported
MyoStrain® Blinded Control Arm52.4Not reported41.763.1Not reported
Combined MyoStrain® Control Arm and Treatment Arm61.5Not reported54.868.1Not reported
CMR left ventricular end-systolic volume index (LVESVI)
Values in percent specificity · Interval/dispersion: 95% Confidence Interval
GroupValueSpreadLowerUpperComment
MyoStrain® Unblinded Treatment Arm99.2Not reported97.6100.0Not reported
MyoStrain® Blinded Control Arm69.0Not reported59.278.9Not reported
Combined MyoStrain® Control Arm and Treatment Arm76.6Not reported70.882.4Not reported
CMR left ventricular stroke volume index (LVSVI)
Values in percent specificity · Interval/dispersion: 95% Confidence Interval
GroupValueSpreadLowerUpperComment
MyoStrain® Unblinded Treatment Arm92.6Not reported87.997.2Not reported
MyoStrain® Blinded Control Arm42.9Not reported32.355.4Not reported
Combined MyoStrain® Control Arm and Treatment Arm90.7Not reported86.894.7Not reported
Complete source fields
classes
  1. categories
    1. measurements
      1. group Id
        OG000
        lower Limit
        70.5
        upper Limit
        85.2
        value
        77.9
      2. group Id
        OG001
        lower Limit
        81.6
        upper Limit
        95.1
        value
        88.4
      3. group Id
        OG002
        lower Limit
        67.6
        upper Limit
        79.6
        value
        73.6
    title
    MyoStrain®
  2. categories
    1. measurements
      1. group Id
        OG000
        lower Limit
        91.2
        upper Limit
        98.9
        value
        95.0
      2. group Id
        OG001
        lower Limit
        84.2
        upper Limit
        96.8
        value
        90.5
      3. group Id
        OG002
        lower Limit
        81.6
        upper Limit
        91.0
        value
        86.3
    title
    CMR LVEF
  3. categories
    1. measurements
      1. group Id
        OG000
        lower Limit
        67.5
        upper Limit
        82.9
        value
        75.2
      2. group Id
        OG001
        lower Limit
        41.7
        upper Limit
        63.1
        value
        52.4
      3. group Id
        OG002
        lower Limit
        54.8
        upper Limit
        68.1
        value
        61.5
    title
    CMR left ventricular end-diastolic indexed (LVEDVI)
  4. categories
    1. measurements
      1. group Id
        OG000
        lower Limit
        97.6
        upper Limit
        100.0
        value
        99.2
      2. group Id
        OG001
        lower Limit
        59.2
        upper Limit
        78.9
        value
        69.0
      3. group Id
        OG002
        lower Limit
        70.8
        upper Limit
        82.4
        value
        76.6
    title
    CMR left ventricular end-systolic volume index (LVESVI)
  5. categories
    1. measurements
      1. group Id
        OG000
        lower Limit
        87.9
        upper Limit
        97.2
        value
        92.6
      2. group Id
        OG001
        lower Limit
        32.3
        upper Limit
        55.4
        value
        42.9
      3. group Id
        OG002
        lower Limit
        86.8
        upper Limit
        94.7
        value
        90.7
    title
    CMR left ventricular stroke volume index (LVSVI)
denoms
  1. counts
    1. group Id
      OG000
      value
      25
    2. group Id
      OG001
      value
      18
    3. group Id
      OG002
      value
      43
    units
    Participants
description
Specificity is defined as the number of true negatives divided by the number of true negatives + number of false positives. * Myocardial dysfunction was defined as the occurrence of either clinical or subclinical cardiotoxicity. * Clinical cardiotoxicity was defined as an absolute change in LVEF \> 10% from baseline to below 53% combined with heart failure symptoms or elevation in NT pro BNP to above 199 pg/mL. * In patients with LVEF \< 53% at baseline, clinical cardiotoxicity was defined by a symptomatic drop in LVEF \> 10% or a HF hospitalization. * Subclinical CTX was defined as an asymptomatic patient with a greater than 10% decrease in LVEF, worsening GLS more than 15% from baseline, or new elevation in NT pro BNP \> 199 pg/mL
dispersion Type
95% Confidence Interval
groups
  1. description
    * After consenting to the PROACT study, patients will undergo a baseline MRI to determine their risk stratification for the study. This baseline MyoStrain® MRI must demonstrate 2 or more segments measuring \>-10% or 9 or more segments \>-17% for entrance into the study as the Higher Risk Group * The unblinded treatment arm will enhance patient management by augmenting standard of care with serial MyoStrain® monitoring of the impact of cancer therapy on myocardial function. * Higher Risk unblinded patients will continue to undergo MyoStrain® MRI testing, regardless of study arm, at 1 month (+1 week), 3 months (+ 1 week), 6 months (+1 week), 12 months (+ 30 days), 24 months (+30 days), and 36 months (+30 days) after the baseline visit. * In addition to the MyoStrain® testing, patients will also be asked to complete a brief patient satisfaction questionnaire at each PROACT time point.
    id
    OG000
    title
    MyoStrain® Unblinded Treatment Arm
  2. description
    * After consenting to the PROACT study, patients will undergo a baseline MRI to determine their risk stratification for the study. This baseline MyoStrain® MRI must demonstrate 2 or more segments measuring \>-10% or 9 or more segments \>-17% for entrance into the study as the Higher Risk group * The blinded control arm will provide investigators with LVEF and LVEDV/LVESV measurements, which are clinical, in conjunction with standard of care * Higher Risk blinded patients will continue to undergo MyoStrain® MRI testing, regardless of study arm, at 1 month (+1 week), 3 months (+ 1 week), 6 months (+1 week), 12 months (+ 30 days), 24 months (+30 days), and 36 months (+30 days) after the baseline visit. * In addition to the MyoStrain® testing, patients will also be asked to complete a brief patient satisfaction questionnaire at each PROACT time point.
    id
    OG001
    title
    MyoStrain® Blinded Control Arm
  3. description
    * After consenting to the PROACT study, patients will undergo a baseline MRI to determine their risk stratification for the study. This baseline MyoStrain® MRI must demonstrate 2 or more segments measuring \>-10% or 9 or more segments \>-17% for entrance into the study as the Higher Risk Group. * After meeting eligibility criteria, patients will be further randomized to an unblinded arm (MyoStrain® measured and available to the treatment team) and a blinded arm (MyoStrain® measured but not available to the treatment team). This randomization will aid in an exploratory aim of testing the feasibility of MyoStrain® to guide cardioprotective therapy in the unblinded vs blinded arms. However, as all patients will have MyoStrain® measured, all patients (both treatment arms) will be combined for testing the primary outcome measure.
    id
    OG002
    title
    Combined MyoStrain® Control Arm and Treatment Arm
param Type
NUMBER
reporting Status
POSTED
time Frame
Through 36 months
title
Specificity of MyoStrain® and CMR Standard Measurements (LV End Diastolic Volume Index, LV End Systolic Volume Index, LV Stroke Volume Index and Left Ventricular Ejection Fraction) to Detect Myocardial Dysfunction During Cancer Treatment
type
PRIMARY
unit Of Measure
percent specificity

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Preserved source evidence · Not medical advice