Presenting Author:

Elizabeth Grier, M.D.

Principal Investigator:

Nausheen Akhter, M.D.

Department:

Medicine

Keywords:

strain, echocardiograpy, trastuzumab, cardiotoxicity

Location:

Ryan Family Atrium, Robert H. Lurie Medical Research Center

C34 - Clinical Women's Health Research

Strain Imaging in Breast Cancer Patients treated with Trastuzumab-based Regimens

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.