Right ventricular function during trastuzumab therapy for breast cancer

Area of Science:

• Cardiology
• Oncology
• Pharmacology

Background:

• Cardiotoxicity (CDT) is a significant adverse effect of trastuzumab (TTZ) therapy in breast cancer patients.
• The specific impact of TTZ on right ventricular (RV) function and its association with subclinical cardiotoxicity remains unclear.

Purpose of the Study:

• To longitudinally assess changes in RV function during TTZ treatment.
• To determine if alterations in RV function are associated with subclinical cardiotoxicity in patients receiving TTZ.

Main Methods:

• Echocardiograms were performed on 25 breast cancer patients at baseline and every 3 months for one year during TTZ therapy.
• Subclinical cardiotoxicity was defined as a ≥12% relative reduction in left ventricular global longitudinal strain (LV GLS).
• Evaluated parameters included LV ejection fraction, LV GLS, RV GLS, and RV Fractional Area Change.

Main Results:

• A significant decrease in LV ejection fraction and a gradual decline in LV GLS were observed during TTZ therapy.
• RV GLS decreased significantly at 3 and 6 months, and RV Fractional Area Change was lower at 6 months.
• Subclinical cardiotoxicity was identified in 52% of patients, but worsening RV parameters did not differ between those with and without subclinical cardiotoxicity.

Conclusions:

• Right ventricular function shows a decline during trastuzumab therapy.
• The observed decrease in RV function during TTZ treatment was not associated with subclinical left ventricular cardiotoxicity in this patient cohort.