Left Ventricular Dysfunction With Trastuzumab Therapy: Is Primary Prevention the Best Option?
Left Ventricular Dysfunction With Trastuzumab Therapy: Is Primary Prevention the Best Option?
复制标题
DOI：
10.1200/jco.2016.71.0038
复制
发表时间：
2017-03-10
影响因子：
45.3
通讯作者：
Amir, Eitan
中科院分区：
文献类型：
--
作者：
Thavendiranathan, Paaladinesh;Amir, Eitan
A 51-year-old women with left-sided, T2N1, grade 3, estrogen receptor-and progesterone receptor-negative, human epidermal growth factor receptor 2 (HER2)-positive breast cancer was referred to a cardio-oncology clinic for pre-cancer treatment cardiovascular risk assessment. The planned cancer treatment was 3 cycles of FEC (fluorouracil, epirubicin [100 mg/m(2) per dose], and cyclophosphamide), followed by 3 cycles of concurrent docetaxel and trastuzumab, followed by maintenance trastuzumab to complete a 1-year course. Other than a prior history of hysterectomy, there was no relevant medical history. Her cardiac history was notable for the absence of prior cardiovascular disease, hypertension, diabetes, or hypercholesterolemia. She was a nonsmoker. At initial clinic visit, her blood pressure was 138/84 with an unremarkable cardiovascular examination. Her echocardiography demonstrated normal sinus rhythm at 73 beats per minute. During cancer treatment, she was observed with echocardiography (baseline left ventricular ejection fraction [LVEF], 61%; global longitudinal strain, -21.5%), cardiac magnetic resonance imaging (CMR, as part of an ongoing study), high-sensitivity troponin I, and B-type natriuretic peptide (Table 1). Given that her baseline evaluations were negative at her initial visit, we discussed whether there were agents to prevent the rare, but serious, complication of congestive heart failure (HF) associated with anthracycline-and trastuzumab-based therapy.
