Left atrial strain is reduced following trastuzumab in breast cancer patients

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Main Authors: Mats C. Højbjerg Lassen, Farzin Arya, Tor Biering‐Sørensen, Jacob L. T. Reeh, Michelle E. Melisko, Shabir Sarwary, Alan H. Baik, Mandar A. Aras, Atif Qasim
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Published: Wiley 2024
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author Mats C. Højbjerg Lassen
Farzin Arya
Tor Biering‐Sørensen
Jacob L. T. Reeh
Michelle E. Melisko
Shabir Sarwary
Alan H. Baik
Mandar A. Aras
Atif Qasim
author_facet Mats C. Højbjerg Lassen
Farzin Arya
Tor Biering‐Sørensen
Jacob L. T. Reeh
Michelle E. Melisko
Shabir Sarwary
Alan H. Baik
Mandar A. Aras
Atif Qasim
Mats C. Højbjerg Lassen
Farzin Arya
Tor Biering‐Sørensen
Jacob L. T. Reeh
Michelle E. Melisko
Shabir Sarwary
Alan H. Baik
Mandar A. Aras
Atif Qasim
collection Wiley Open Access
contents Left atrial strain is reduced following trastuzumab in breast cancer patients Mats C. Højbjerg Lassen Farzin Arya Tor Biering‐Sørensen Jacob L. T. Reeh Michelle E. Melisko Shabir Sarwary Alan H. Baik Mandar A. Aras Atif Qasim Echocardiography 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. 10.1111/echo.15751 http://onlinelibrary.wiley.com/termsAndConditions#vor
doi_str_mv 10.1111/echo.15751
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spellingShingle Left atrial strain is reduced following trastuzumab in breast cancer patients
Mats C. Højbjerg Lassen
Farzin Arya
Tor Biering‐Sørensen
Jacob L. T. Reeh
Michelle E. Melisko
Shabir Sarwary
Alan H. Baik
Mandar A. Aras
Atif Qasim
Echocardiography
Left atrial strain is reduced following trastuzumab in breast cancer patients Mats C. Højbjerg Lassen Farzin Arya Tor Biering‐Sørensen Jacob L. T. Reeh Michelle E. Melisko Shabir Sarwary Alan H. Baik Mandar A. Aras Atif Qasim Echocardiography 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. 10.1111/echo.15751 http://onlinelibrary.wiley.com/termsAndConditions#vor
title Left atrial strain is reduced following trastuzumab in breast cancer patients
topic Echocardiography
url https://onlinelibrary.wiley.com/doi/10.1111/echo.15751