TITLE:
Long Term Follow-Up of Cardiotoxicity in Breast Cancer Treatment: A Case Report
AUTHORS:
Jose Luis Siller-Nava, Adrian Espejel-Guzman, Javier Serrano-Roman, Aldo Cabello-Ganem, Alexis D. Aparicio Ortiz, Nilda Espinola-Zavaleta
KEYWORDS:
Cardiotoxicity, Breast Cancer, Global Longitudinal Strain, Left Ventricular Ejection Fraction, Heart Failure
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.13 No.3,
March
31,
2023
ABSTRACT: Background: Cardiac toxicity is currently defined as a symptomatic decrease in Left Ventricular Ejection Fraction (LVEF) of more than 5% or an asymptomatic decrease of at least 10% to a value of under 50% in repeated evaluations on conventional transthoracic echocardiogram (TTE), as well as a Global Longitudinal Strain (GLS) value Aims: To highlight using GLS rather than modified Simpson 2D-LVEF for the evaluation of long-term cardiotoxicity. Case Presentation: The case concerns a 73-year-old female patient with a history of breast cancer chemotherapy and anthracyclines-based therapy who presented symptoms of late cardiac toxicity related to the chemotherapeutic treatment. In the following years, the patient remained asymptomatic with a 2D-LVEF of 48%, dilation of the left atrium was found, and the reservoir phase strain was severely decreased. Conclusion: The preferred method for evaluating cardiovascular complications associated with chemotherapy is the TTE, which is performed prior to the start of treatment, during therapy, and in the follow-up. Myocardial deformation as a predictor of cardiotoxicity allows the identification of subclinical heart failure.