title: Cardiac Surveillance Findings During Adjuvant and Palliative Trastuzumab Therapy in Patients with Breast Cancer.
abstract: OBJECTIVE
  Trastuzumab therapy, the standard treatment for human epidermal growth factor receptor type-2 (HER2)-positive breast cancer, is associated with possible cardiotoxicity. We set out to retrospectively analyze the cardiac follow-up data of patients with breast cancer receiving trastuzumab treatment.
  
  
  METHODS
  The study involved 47 and 31 patients receiving adjuvant or palliative chemotherapy plus trastuzumab, respectively. Cardiovascular system assessments including echocardiography were regularly performed.
  
  
  RESULTS
  A significant heart abnormality was detected in 44.7% of the operable and 41.9% of metastatic cases. In the adjuvant setting, left ventricular ejection fraction changes occurred mostly during treatment and less frequently after its completion (40.4% vs. 19.4%), while in the palliative setting, 35.5% and 40% in the first and the second year of therapy. An asymptomatic atrial septum aneurysm was detected in 8.5% and 13% of the patients in the two groups.
  
  
  CONCLUSIONS
  Trastuzumab-related cardiotoxicity is mostly manifested in an asymptomatic decrease in left ventricular ejection fraction; hypertension, a high body mass index and left-sided irradiation are its predictors.
authors.affiliation: Department of Oncotherapy, University of Szeged, Szeged, Hungary.
authors.forename: Erzsébet
authors.initials: E
authors.lastname: Valicsek
authors.affiliation: Department of Oncotherapy, University of Szeged, Szeged, Hungary.
authors.forename: Renáta
authors.initials: R
authors.lastname: Kószó
authors.affiliation: Department of Oncotherapy, University of Szeged, Szeged, Hungary.
authors.forename: Ágnes
authors.initials: Á
authors.lastname: Dobi
authors.affiliation: Department of Oncotherapy, University of Szeged, Szeged, Hungary.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Uhercsák
authors.affiliation: Department of Oncotherapy, University of Szeged, Szeged, Hungary.
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Varga
authors.affiliation: Second Department of Medicine and Cardiology Center, University of Szeged, Szeged, Hungary.
authors.forename: Andrea
authors.initials: A
authors.lastname: Vass
authors.affiliation: Second Department of Medicine and Cardiology Center, University of Szeged, Szeged, Hungary.
authors.forename: Éva
authors.initials: É
authors.lastname: Jebelovszky
authors.affiliation: Department of Oncotherapy, University of Szeged, Szeged, Hungary kahan.zsuzsanna@med.u-szeged.hu.
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Kahán
mesh_terms: D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D005260:Female; D006321:Heart / Q000503:physiopathology; D006334:Heart Function Tests; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009362:Neoplasm Metastasis; D010166:Palliative Care; D011159:Population Surveillance; D012307:Risk Factors; D000068878:Trastuzumab / Q000627:therapeutic use*
chemical_list: D000068878:Trastuzumab
keywords: BMI; Trastuzumab; cardiac dysfunction; hypertension; radiotherapy; risk factor