Left atrial strain is reduced following trastuzumab in breast cancer patients

Author:

Lassen Mats C. Højbjerg1ORCID,Arya Farzin2,Biering‐Sørensen Tor13,Reeh Jacob L. T.1,Melisko Michelle E.4,Sarwary Shabir2,Baik Alan H.2,Aras Mandar A.2,Qasim Atif2

Affiliation:

1. Department of Cardiology Herlev & Gentofte Hospital, University of Copenhagen Hellerup Denmark

2. Department of Medicine Division of Cardiology UCSF Medical Center, University of California San Francisco San Francisco California USA

3. Department of Biomedical Sciences Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark

4. Department of Medicine Division of Hematology & Oncology UCSF Medical Center, University of California San Francisco San Francisco California USA

Abstract

AbstractBackgroundThe effect of trastuzumab therapy on left atrial (LA) function remains largely unknown. Our aim was to assess the changes in LA strain parameters longitudinally in patients treated with trastuzumab.MethodsWe retrospectively studied 170 patients with stage I‐IV HER2+ breast cancer. All patients had baseline echocardiograms and repeat echocardiograms at 3 months and after 1 year. We measured LA strain at all three time points. Changes in LA strain and strain rate (sr) parameters were evaluated using repeated‐measures mixed‐effects models. The cohort was stratified according to development of cancer therapeutics‐related cardiac dysfunction (CTRCD) during follow‐up.ResultsThe mean age was 52.7 ± 13.8 years, 25.3% had hypertension and 16.0% had metastatic disease. Multiple LA strain parameters (predicted delta value, [95%CI]) showed statistically significant declines in patients who developed CTRCD from baseline to the 3‐month follow‐up after multivariable adjustment; LA reservoir strain (LAεres): −4.7%; [−8.1% to −1.3%], p = .007; LA conduit strain (LAεcon): −2.8%; [−5.3% to −.4%], p = .021); and LAεres sr: −.2/s; [−.3/s to −.09/s], p < .001). In patients who did not develop CTRCD, LA strain parameters declined significantly but to a smaller degree than in the CTRCD group (LAεres: −1.7%; [−3.1% to −.3%], p = .020, LAεcon: −2.2%; [−3.3% to −1.1%], p < .001, and LA booster pump strain : −2.4%; [−3.5% to −1.4%], p < .001). LA strain rates did not decline significantly in the non‐CTRCD group.ConclusionTrastuzumab treatment was associated with declines in LA strain parameters in patients with breast cancer. The largest declines were observed in patients who developed CTRCD during treatment.

Funder

Lundbeck Foundation

Publisher

Wiley

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