Comprehensive proteomic and metabolomic profiling reveals 203 proteins and 16 metabolites significantly associated with cardiac structure and function in breast cancer patients undergoing anthracycline and/or trastuzumab therapy.
Cathepsin C identified as a key protein linked to left ventricular ejection fraction (LVEF), longitudinal strain, left atrial volume index, and incident cardiac dysfunction.
Enriched pathways include protein deubiquitination, protein modification, macromolecule catabolic processes, and global metabolic pathways, underscoring complex biological mechanisms underlying cardiotoxicity.
Amino acid–related metabolites such as n-acetylglutamine and aspartic acid show strong associations with reductions in cardiac function metrics, pointing to metabolic alterations during cardiotoxic therapy.
