Early Asymptomatic Decline in Left Ventricular Ejection Fraction in Adult Cancer Patients Receiving Trastuzumab

Authors

  • Mansoor Zeeshan Department of Medicine, Combined Military Hospital, Lahore/National University of Medical Sciences (NUMS) Pakistan
  • Faisal Mehmood Department of Medicine, Combined Military Hospital, Lahore/National University of Medical Sciences (NUMS) Pakistan
  • Zareen Gul Department of Medicine, Combined Military Hospital, Lahore/National University of Medical Sciences (NUMS) Pakistan
  • Maryam Khan Department of Medicine, Combined Military Hospital, Lahore/National University of Medical Sciences (NUMS) Pakistan
  • Amna Ashraf Department of Medicine, Combined Military Hospital, Lahore/National University of Medical Sciences (NUMS) Pakistan
  • Muhammad Umair Shafique Department of Medicine, Combined Military Hospital, Lahore/National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v73iSUPPL-1.8608

Keywords:

Cardiotoxicity, Echocardiographic monitoring, Trastuzumab

Abstract

Objective: To determine the frequency of Trastuzumab-induced early asymptomatic decline in left ventricular ejection fraction by serial Echocardiography and to identify various risk factors associated with cardio-toxicity.

Study Design: Quasi-experimental study.

Place and Duration of Study: Oncology Department, Combined Military Hospital, Lahore Pakistan, from Jan to Jun 2021.

Methodology: Patients who were started on Trastuzumab-based chemotherapy and had completed at least 600 mg subcutaneously every three weeks (amounting to 17 doses) in 1 year were enrolled. Surveillance modalities include Electrocardiography, chest X-ray and Echocardiography. These were done at baseline and after four cycles of chemotherapy. All patients were evaluated for the presence of the following risk factors: diabetes mellitus, hypertension, pre-existing coronary artery disease, and chest wall. Asymptomatic cardiac dysfunction was defined as an ejection fraction (EF) fall greater than 10% on follow-up echocardiography with minimum or no symptoms.

Results: The average baseline LVEF was 63.16±2.42 %, which decreased significantly to an average EF of 59.67±6.10%. In our study, 40 patients (66.7%) showed no decline in LVEF post-completion of chemotherapy. 6 patients (10.0%) showed an insignificant <10% decline in LVEF, and 14 patients (23.3%) showed significant >10% decline in LVEF. Frequency of decline in LVEF was observed in 20 out of 60 patients (33.33%), with 14 out of 60 patients (23%) having significant (i.e., ≥10%) decline in LVEF and 6 out of 10 patients (10%) having insignificant (i.e.,≤ 10%) decline in LVEF.

Conclusion: This entails regular monitoring for cardiac dysfunction by Echocardiography during Trastuzumab treatment.

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Published

28-07-2023

Issue

Section

Original Articles

How to Cite

1.
Mansoor Zeeshan, Faisal Mehmood, Zareen Gul, Maryam Khan, Ashraf A, Muhammad Umair Shafique. Early Asymptomatic Decline in Left Ventricular Ejection Fraction in Adult Cancer Patients Receiving Trastuzumab. Pak Armed Forces Med J [Internet]. 2023 Jul. 28 [cited 2024 Jul. 23];73(4):1204-7. Available from: https://pafmj.org/PAFMJ/article/view/8608