Assessment of Echocardiography for Prediction of Subclinical Cardiotoxicity in Breast Cancer Women Treated with Adjuvant Trastuzumab

Back ground: The monoclonal antibody trastuzumab has greatly improved the prediction for breast cancer patients who are HER-2-positive; however it is also linked to cardiotoxicity. This research demonstrated the consequences of Trastuzumab on echocardiography parameters to assess the cardiotoxicity. Patients and Method: This study included 100 patients planned to receive adjuvant Trastuzumab in the period between January 2022 and December 2022 with the following criteria: > 18 years old, with non-metastatic breast cancer tested positive for HER-2 (stage I - III) who received neoadjuvant or adjuvant trastuzumab every 21 days after receiving (AC) protocol. Quantitative data was described using either medians and minimum-maximum values (range) or means and standard deviations. While qualitative data will be presented as percentages. Any results with a p-value lower than 0.05 will be considered statistically significant. Results: 20 patients (20%) stopped trastuzumab at one cycle or more during the studied four cycles due to either decline in EF or symptomatic HF. In subgroup analysis, significant increase in LVEDd, LVESd, LVEDV and LVESV with respective P values 0.003, 0.019, 0.02 and 0.001. E⸌, E/E⸌, Peak TR Velocity mean score statistically increased with P value 0.04, 0.02, 0.017 respectively. Conclusion: According to the data presented in this study, TZM could significantly affect ECHO parameters including LVEDD, LVEDV, LVESV, LA, E⸌, E/E⸌, Peak TR Velocity, EF, Septal S⸌ and TAPSE.  Key words: Trastuzumab, Cardio-oncology, cardiotoxicity, echocardiography.