Left Ventricular Dysfunction With Trastuzumab Therapy: Is Primary Prevention the Best Option?
Paaladinesh Thavendiranathan1, Eitan Amir1
1Paaladinesh Thavendiranathan, Ted Rogers Program in Cardiotoxicity Prevention, University Health Network, Toronto, Ontario, Canada; and Eitan Amir, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
Summary
This case study explores cardiovascular risk in a HER2-positive breast cancer patient undergoing chemotherapy. It discusses preventative strategies for heart failure during treatment with anthracyclines and trastuzumab.
Area of Science:
- Cardio-oncology
- Breast Cancer Therapeutics
- Cardiovascular Risk Assessment
Background:
- A 51-year-old woman with HER2-positive breast cancer was evaluated for cardiovascular risk prior to chemotherapy.
- Treatment plan included FEC, docetaxel, and trastuzumab, known to pose cardiac risks.
Observation:
- Baseline echocardiography showed normal left ventricular ejection fraction (61%) and global longitudinal strain (-21.5%).
- Patient had no prior cardiovascular disease, hypertension, diabetes, or hypercholesterolemia.
Findings:
- The patient's cardiac status was monitored using echocardiography, cardiac MRI, troponin I, and B-type natriuretic peptide.
- Discussion focused on potential agents to prevent cardiotoxicity from anthracycline and trastuzumab therapy.
Implications:
- Highlights the importance of pre-treatment cardiovascular assessment in breast cancer patients.
- Emphasizes the need for proactive strategies to mitigate heart failure risk during HER2-targeted and anthracycline-based chemotherapy.
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