TY - JOUR

T1 - Left atrial strain is reduced following trastuzumab in breast cancer patients

AU - Lassen, Mats C.Højbjerg

AU - Arya, Farzin

AU - Biering-Sørensen, Tor

AU - Reeh, Jacob L.T.

AU - Melisko, Michelle E.

AU - Sarwary, Shabir

AU - Baik, Alan H.

AU - Aras, Mandar A.

AU - Qasim, Atif

N1 - Publisher Copyright: © 2024 Wiley Periodicals LLC.

PY - 2024

Y1 - 2024

N2 - Background: The 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. Methods: We 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. Results: The 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. Conclusion: Trastuzumab 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.

AB - Background: The 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. Methods: We 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. Results: The 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. Conclusion: Trastuzumab 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.

KW - breast cancer

KW - cardiac toxicity

KW - cardiotoxicity

KW - LA strain

KW - left atrium

KW - speckle-tracking echocardiography

KW - strain

KW - trastuzumab

U2 - 10.1111/echo.15751

DO - 10.1111/echo.15751

M3 - Journal article

C2 - 38284677

AN - SCOPUS:85182981994

VL - 41

JO - Echocardiography: A Journal of Cardiovascular Ultrasound and Allied Techniques

JF - Echocardiography: A Journal of Cardiovascular Ultrasound and Allied Techniques

SN - 0742-2822

IS - 1

M1 - e15751

ER -