Author + information
- Elizabeth Grier,
- Siri Kunchakarra,
- Sumeet Mitter,
- Nicholas Furiasse and
- Nausheen Akhter
Background: Trastuzumab is known to increase the risk of cardiotoxicity when combined with anthracycline agents. This study assesses the independent effects of trastuzumab in current non-anthracycline-based regimens on left ventricular function using echocardiographic strain imaging.
Methods: 34 patients with Human Epidermal Growth Factor Receptor 2 (HER2) positive breast cancer who were treated with non-anthracycline trastuzumab-based regimens at a single center underwent standard two-dimensional (2D) echocardiograms prior to starting chemotherapy, and again at three-month intervals during therapy. 2D speckle-tracking strain was retrospectively obtained using EchoInsight software. Statistical analysis used a Wilcoxon rank-sum test to compare variables between patients with and without cardiotoxicity, defined as a reduction in left ventricular ejection fraction (LVEF) of 10% or more at any point during follow-up.
Results: 10 patients developed cardiotoxicity during therapy. Results are listed in Table 1. A significant reduction in global longitudinal strain (GLS) preceded the decrease in LVEF. A significant decrease in global circumferential strain (GCS) was demonstrated after a change in GLS.
Conclusions: Trastuzumab demonstrates a risk of cardiotoxicity independent of the effects of anthracyclines. Close cardiac surveillance with current non-anthracycline trastuzumab-based regimens is still needed. Changes in GLS precede changes in LVEF and GCS.
Moderated Poster Contributions
Non Invasive Imaging Moderated Poster Theater, Poster Hall, Hall C
Saturday, March 18, 2017, 10:00 a.m.-10:10 a.m.
Session Title: Advances in Imaging to Assess Cardiotoxicity
Abstract Category: 28. Non Invasive Imaging: Echo
Presentation Number: 1215M-05
- 2017 American College of Cardiology Foundation