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• W4313443584 abstract "Trastuzumab (TZ), a monoclonal antibody, is used for the treatment of HER2- positive breast cancer, with a marked improvement in its prognosis. However, it is associated with significant left ventricular (LV) cardiotoxicity. But TZ related right ventricular (RV) dysfunction and its prognostic implications have rarely been reported. Determine the incidence and prognostic value of RV dysfunction cardiotoxicity. We conducted a prospective study carried out at the Casablanca cardio-oncology unit from January 2017 to December 2021. The echocardiographic evaluation is carried out pre- and post-chemotherapy. LVEF, RV Function, Systolic Tricuspid Annulus Plane Excursion (TAPSE) and Peak the S wave in pulsed tissue Doppler mode (S’VD), pulmonary arterial pressure (PAPS), Vmax of the TI, the size of the IVC, were measured by echocardiography. A total of 1,648 patients were recruited to the cardio-oncology unit with a total of 1,356 patients diagnosed with breast cancer, the average age was 53 ± 11 years (17–83). Of these patients, 795 (58.6%) were on trastuzumab. Trastuzumab-induced cardiotoxicity (TIC) was defined as a decrease in LVEF > 10% at the lower limit of normal of 50%, symptomatic or not, after administration of trastuzumab. An alteration of LVEF was found in 107 cases (13.4%). Of these patients, 75 (70%) were symptomatic with NYHA stage II to III dyspnea. Concerning the alteration of the RV concomitant with the alteration of the LV, 18 patients (16.8%) had a TAPSE < 17 mm with an S’RV < 9.5 m/s, with signs of right overload defined by PAPS > 34 mmHg in 10 patients, Vmax > 3.4 m/s in 7 patients, and dilated IVC in 6 patients. During the follow-up, the cessation of chemotherapy for all patients associating the biventricular alteration was mandatory with administration of the treatment of heart failure: beta-blocker, ACE inhibitor, and Aldactone and close monitoring every month. Reversibility was noted in 9 patients with biventricular cardiotoxicity, with a control LVEF of 53% ± 5, and a TAPSE > 18 mm, after 6 months of post-chemotherapy follow-up. TIC in patients with HER2+ breast cancer is often reversible. But the presentation of a concomitant dysfunction of the LV and the RV makes this reversibility weaker. This suggests that RV dysfunction has very important prognostic value and its persistence during follow-up needs to be evaluated in further studies." @default.
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• W4313443584 date "2023-01-01" @default.
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• W4313443584 title "Evaluation of right ventricular dysfunction concomitant to left ventricular dysfunction in cardiotoxicity induced by trastuzumab in patients followed for HER2+ breast cancer: Experience of the first cardio-oncology unit in Morocco" @default.
• W4313443584 doi "https://doi.org/10.1016/j.acvdsp.2022.10.318" @default.
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