title: Heart remodeling induced by adjuvant trastuzumab-containing chemotherapy for breast cancer overexpressing human epidermal growth factor receptor type 2: a prospective study.
abstract: We aimed to investigate the cardiac changes in patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer treated with trastuzumab in an adjuvant setting. Two hundred and fifty-three women with HER2-positive breast cancer were included. The assessment of cardiovascular system and echocardiography were performed and compared at baseline, at the termination of trastuzumab therapy and 6 months latter. Left heart remodeling was defined arbitrary as the change in at least one of the analyzed echocardiographic parameters of ≥standard deviation (SD) (in model I) or ≥2×SD (in model II) after 6-month follow-up. After 6-month follow-up 39 (31.7%), 27 (22%), 14 (11.4%), 10 (8.1%), 5 (4.1%) and 1 (0.8%), women had at least one parameter with a change exceeding mean difference ≥SD, respectively; and 30 (24.4%), 9 (7.5%), 3 (2.4%), 2 (1.6%) 1 (0.8%) exceeding mean difference ≥2SD. In stepwise multivariate regression analysis sedentary life style (OR16.7, p=0.003), positive cardiovascular family history (OR 6,9; p=0.013) and left ventricular ejection fraction change after 3 months (OR 1.2; p=0.007) were independent predictors of left heart remodeling in model I, whereas hypertension (OR 5.6; p=0.06) and positive cardiovascular family history (OR 3.9; p=0.032) were independent predictors of heart remodeling in model II. In conclusion, trastuzumab induces LV and left atrial cavity dilatation together with LV systolic function impairment.
authors.affiliation: Department of Cardiology, N. Copernicus Memorial Hospital, Lodz, Poland. Electronic address: gpiotr4@wp.pl.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Piotrowski
authors.forename: Rafał
authors.initials: R
authors.lastname: Gawor
authors.forename: Robert C
authors.initials: RC
authors.lastname: Bourge
authors.forename: Arkadiusz
authors.initials: A
authors.lastname: Stasiak
authors.forename: Piotr
authors.initials: P
authors.lastname: Potemski
authors.forename: Zenon
authors.initials: Z
authors.lastname: Gawor
authors.forename: Navin C
authors.initials: NC
authors.lastname: Nanda
authors.forename: Maciej
authors.initials: M
authors.lastname: Banach
mesh_terms: D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects* / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001940:Breast / Q000187:drug effects / Q000378:metabolism / Q000473:pathology; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D066246:ErbB Receptors / Q000378:metabolism*; D005260:Female; D006321:Heart / Q000187:drug effects* / Q000503:physiopathology*; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D000068878:Trastuzumab
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D066246:ErbB Receptors; D000068878:Trastuzumab
keywords: Breast cancer; Cardiotoxicity; Heart failure; Remodeling; Trastuzumab