Trastuzumab -Induced Cardiomyopathy Evaluation by Combined Echocardiography and Biomarkers in Patients with Breast Cancer

Trastuzumab (Herceptin) is a monoclonal antibody used in the treatment of patients with breast cancer. This drug can cause cardiomyopathy. We evaluated the effects of Trastuzumab on the heart and Trastuzumab-induced cardiomyopathy 3 months after the initiation of the drug in patients with breast cancer. This observational cross-sectional analytical study, conducted between 2013 and 2014 in Imam Khomeini Hospital of Tehran University Of Medical Sciences, recruited 40 female patients with breast cancer. Findings related to cardiomyopathy were determined and compared before and 3 months after starting Trastuzumab. Diastolic function was exacerbated after the treatment course significantly: 25.9% of the patients before treatment and 43.6% after treatment had diastolic dysfunction (P = 0.001). Ejection fraction (EF) was reduced significantly after treatment (P = 0.002): 0% of the patients before treatment and 10.3% after treatment had an EF < 45%. Cardiac enzyme troponin I showed a significant rise after treatment: 0% of the patients before treatment and 6.7% after treatment had troponin I > 0.1. Our results demonstrated that Trastuzumab caused cardiomyopathy in some of our breast cancer patients. Therefore, cardiac monitoring of patients who use this agent is necessary at regular and close intervals.