title: Trastuzumab-induced cardiotoxicity: the role of two-dimensional myocardial strain imaging in diagnosis and management.
abstract: A 45-year-old female breast cancer patient developed heart failure during adjuvant trastuzumab therapy. Her initial left ventricular ejection fraction (LVEF) was 39% and corresponding global longitudinal and circumferential systolic strain measurements were also significantly reduced. Trastuzumab was ceased and supportive cardiac therapy commenced. The ensuing LVEF and systolic strain measurements showed consistent improvement so that trastuzumab was recommenced (while supportive cardiac therapy continued). At this point, reduced circumferential systolic strain with preserved LVEF was observed. Subsequent echocardiograms revealed further reductions in circumferential and longitudinal systolic strain without reductions in LVEF.
authors.affiliation: Medical Imaging and Radiation Sciences Research Group, Faculty of Health Science, University of Sydney, New South Wales, Australia. pwstoodley@gmail.com
authors.forename: Paul
authors.initials: P
authors.lastname: Stoodley
authors.forename: David
authors.initials: D
authors.lastname: Tanous
authors.forename: David
authors.initials: D
authors.lastname: Richards
authors.forename: Steve
authors.initials: S
authors.lastname: Meikle
authors.forename: Jillian
authors.initials: J
authors.lastname: Clarke
authors.forename: Rina
authors.initials: R
authors.lastname: Hui
authors.forename: Liza
authors.initials: L
authors.lastname: Thomas
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects*; D000970:Antineoplastic Agents / Q000009:adverse effects; D004452:Echocardiography / Q000379:methods*; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006333:Heart Failure / Q000139:chemically induced* / Q000000981:diagnostic imaging* / Q000517:prevention & control; D006801:Humans; D008875:Middle Aged; D000068878:Trastuzumab; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000139:chemically induced* / Q000000981:diagnostic imaging* / Q000517:prevention & control
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D000068878:Trastuzumab