Author/Editor		Matos, Erika; Jug, Borut; Vidergar-Kralj, Barbara; Zakotnik, Branko
Title		Cardiac monitoring in patients on trastuzumab
Type		članek
Vol. and No.		Letnik 65, št. 3
Publication year		2017
Volume		str. 288-298
ISSN		1827-1618 - Minerva cardioangiologica
Language		eng
Abstract		Guidance on cardiac surveillance during adjuvant trastuzumab therapy remains elusive. The recommended methods are 2-dimensional echocardiography (2D-ECHO) and electrocardiography gated equilibrium radionuclide ventriculography (RNV). We assessed the correlation and possible specific merits of these two methods. METHODS: In a prospective cohort study in patients undergoing post-anthracycline adjuvant trastuzumab therapy, clinical assessment, 2D-ECHO and RNV were performed at baseline, 4, 8 and 12 months. The correlation between used methods was estimated with Pearson's correlation coefficient and Bland-Altman analysis. RESULTS: 92 patients (mean age 53.6 % 9.0 years) were included. The correlation of LVEF measured by ECHO and RNV at each time point was statistically insignificant. Values obtained by ECHO were on average higher (3.7% to 4.5%). A decline in LVEF of % 10% from baseline was noticed in 19 (24.4%) and 13 (14.9%) patients with ECHO and RNV, respectively, however in only one patient by both methods simultaneously. A decline in LVEF of % 10% to below 50% was found in three and none patients according to RNV and ECHO measurements, respectively. CONCLUSIONS: There is a weak correlation of ECHO and RNV measurements in individual patient, the results obtained by the methods are not interchangeable. LVEF values determined by 2D- ECHO were on average higher compared to RNV determined ones. When in an asymptomatic patient a decline in LVEF requiring treatment interruption is detected by RNV ECHO re-evaluation and referral to a cardiologist is advised.
Keywords		trastuzmab elektrokardiografija radionuklidna ventrikulografija ehokardiografija klinične študije radionuclide ventriculography electrocardiography echocardiography