CARDIOVASCULAR JOURNAL OF AFRICA • SMC-PAFCIC Abstracts October 2022 21 AFRICA Submission ID: 1400 EVALUATION OF RIGHT VENTRICULAR DYSFUNCTION CONCOMITANT TO LEFT VENTRICULAR DYSFUNCTION IN CARDIOTOXICITY INDUCED BY TRASTUZUMAB IN PATIENTS FOLLOWED FOR HER2+ BREAST CANCER: EXPERIENCE OF THE CARDIO-ONCOLOGY UNIT AT IBN ROCHD HOSPITAL UNIVERSITY, CASABLANCA. H. BENDAHOU, A. ABOURICHE, A. MAAROUFI, S. BELKOUCHIA, H. KARMOUCHI, S. ZAGDANE, S. EJJEBLI, M. HABOUB, S. AROUS, G. BENNOUNA, R. HABBAL, S. ZAFAD, M. DAKIR, K. FARES ARAB, S. SAHRAOUI, N. TAWFIK MOROCCO Introduction: Trastuzumab (TZ), a monoclonal antibody, is used for the treatment of HER2- positive breast cancer, with a marked improvement in its prognosis. However, it is associated with significant left ventricular (LV) cardiotoxicity. But TZ related right ventricular (RV) dysfunction and its prognostic implications have rarely been reported. Objective: Determine the incidence and prognostic value of RV dysfunction cardiotoxicity. Method: We conducted a prospective study carried out at the Casablanca cardio-oncology unit from January 2017 and April 2022. The echocardiographic evaluation is carried out pre and post chemotherapy. LVEF, RV Function (Systolic Tricuspid Annulus Plane Excursion (TAPSE) and Peak the S wave in pulsed tissue Doppler mode (S’VD), pulmonary arterial pressure (PAPS), Vmax of the TI, the size of the IVC, were measured by echocardiography. Results: A total of 2329 patients were recruited to the cardio-oncology unit with a total of 2284 patients diagnosed with breast cancer, the average age was 53 ± 11 years. Of these patients, 1338 (58.6%) were on Trastuzumab. Trastuzumab-induced cardiotoxicity (TIC) was defined as a decrease in LVEF >10% at the lower limit of normal of 50%, after administration of trastuzumab. An alteration of LVEF was found in 306 cases (13.4%). Of this patients, 214 (70%) were symptomatic. Concerning the alteration of the RV concomitant with the alteration of the LV, 51 patients (16.8%) had a TAPSE<17mm with an S’RV<9.5m/s, with signs of right overload defined by PAPS>34mmHg in 18 patients, Vmax>3,4m/s in 14 patients, and dilated IVC in 13 patients. During the follow-up, the cessation of chemotherapy for all patients associating the biventricular alteration was mandatory with administration of the treatment of heart failure: beta-blocker, ACE inhibitor, and Aldactone and close monitoring every month. Reversibility was noted in 17 patients with biventricular cardiotoxicity, with a control LVEF of 53%±5, and a TAPSE>18mm, after 6 months of post-chemotherapy follow-up. Conclusion: TIC in patients with HER2+ breast cancer is often reversible. But the presentation of a concomitant dysfunction of the LV and the RV makes this reversibility weaker. This suggests that RV dysfunction has very important prognostic value and its persistence during follow-up needs to be evaluated in further studies. Submission ID: 1401 MANAGEMENT OF HYPERTENSION IN SEVERE FORMS OF POSTERIOR REVERSIBLE ENCEPHALOPATHY SYNDROM (PRES) H.EL GHIATI, J. FAGOURI, N. MOUINE, A. BENYASS, H.BALKHI MOROCCO Background: The PRES is a clinical-radiological syndrome indicating spontaneously reversible brain suffering. It combines essentially neurological manifestations with white matter signal abnormalities in magnetic resonance imaging. The aim of our work is to focus on the clinical and evolutionary features of severe forms of PRES in order to identify therapeutic (especially the management of hypertension) and prognostic considerations. Materials and methods: This is a retrospective study conducted in the surgical intensive care unit (ICU) of the Mohamed V Military Training Hospital of Rabat over a period of 13 years including severe forms of PRES. Results: Eleven cases of PRES in its severe forms have been collected. The average age was 30 years with a clear predominance of women (90.91%). High blood pressure was present in all cases. Neurological signs were mainly represented by generalized seizures, headache and confounding syndrome. Two patients had status epilepticus, while one had respiratory distress following acute pulmonary edema. In addition, one patient had brainstem injury. After adequate medical management, the evolution was favorable in all patients with complete clinical-radiological reversibility despite their initial severity. Conclusion: Management of hypertension is crucial in serious forms of PRES. An adapted treatment helps prevent permanent neurological sequelae and ensure clinical-radiological reversibility. MODERATED POSTER SESSION
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