Incidence, Predictors of Diastolic Dysfunction Post-Anthracyclines in Breast Cancer

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Clinicians may have a better way to identify patients at higher risk for developing a clinically relevant anthracycline cardiotoxicity.
Clinicians may have a better way to identify patients at higher risk for developing a clinically relevant anthracycline cardiotoxicity.

Cardiotoxicity majorly limits the administration of anthracyclines or trastuzumab in patients with breast cancer

Clinicians may have a better way to identify patients at higher risk for developing a clinically relevant anthracycline cardiotoxicity from those at lower risk and tailor monitoring programs according to risk, according to an article published online ahead of print in The Oncologist.

Researchers performed an analytical, observational cohort study that included 100 consecutive patients receiving anthracycline-based chemotherapy (CHT) for breast cancer.

The purpose was to evaluate the incidence, evolution, and predictors of diastolic dysfunction (DD) in patients with breast cancer treated with anthracyclines.

All patients underwent clinical evaluation, echocardiogram, and measurement of cardiac biomarkers at baseline, end of anthracycline-based CHT, and at 3 months and 9 months after anthracycline-based CHT was completed. 

Fifteen patients receiving trastuzumab were followed with two more visits at 6 and 12 months post-anthracycline-based CHT. Out of the 100 patients, 15 had baseline DD and were excluded from the analysis.

RELATED: During Trastuzumab Therapy, Many Patients May Have Suboptimal Cardiac Monitoring

Results showed that at the end of follow-up (median 12 months), 49 patients (57.6%) developed DD. It was persistent in 73% of patients, but reversible in 27%.

Four patients developed cardiotoxicity, and none of the patients with normal diastolic function developed systolic dysfunction during follow-up. 

A logistic regression model showed that body mass index and age were independently related to DD. Cardiac biomarkers and clinical variables were not predictors of DD.

Reference

  1. Serrano JM, Gonzalez I, Del Castillo S, et al. Diastolic dysfunction following anthracycline-based chemotherapy in breast cancer patients: incidence and predictors. Oncologist. 2015. [epub ahead of print]. doi: 10.1634/theoncologist.2014-0500.

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