Recovery from left ventricular dysfunction was associated with the early introduction of heart failure medical treatment in cancer patients with anthracycline-induced cardiotoxicity.
Adult
Aged
Anthracyclines
/ adverse effects
Antibiotics, Antineoplastic
/ adverse effects
Cardiotoxicity
Cardiovascular Agents
/ therapeutic use
Female
Heart Failure
/ chemically induced
Humans
Male
Middle Aged
Neoplasms
/ drug therapy
Recovery of Function
Retrospective Studies
Risk Factors
Time Factors
Treatment Outcome
Ventricular Dysfunction, Left
/ chemically induced
Ventricular Function, Left
/ drug effects
Anthracycline
Cardiotoxicity
Heart failure
Medical treatment
Journal
Clinical research in cardiology : official journal of the German Cardiac Society
ISSN: 1861-0692
Titre abrégé: Clin Res Cardiol
Pays: Germany
ID NLM: 101264123
Informations de publication
Date de publication:
Jun 2019
Jun 2019
Historique:
received:
01
08
2018
accepted:
15
10
2018
pubmed:
28
10
2018
medline:
20
12
2019
entrez:
28
10
2018
Statut:
ppublish
Résumé
Left ventricular (LV) dysfunction due to anthracycline-induced cardiotoxicity (AIC) has been believed to be irreversible. However, this has not been confirmed and standard medical treatment for heart failure (HF) including renin-angiotensin inhibitors and β-blockers may lead to its recovery. We thus retrospectively studied 350 cancer patients receiving anthracycline-based chemotherapy from 2001 to 2015 in our institution. Fifty-two patients (14.9%) developed AIC with a decrease in LV ejection fraction (LVEF) of 24.1% at a median time of 6 months [interquartile range (IQR) 4-22 months] after anthracycline therapy. By multivariate analysis, AIC was independently associated with cardiac comorbidities including ischemic heart disease, valvular heart disease, arrhythmia, and cardiomyopathy [odds ratio (OR) 6.00; 95% confidence interval (CI) 2.27-15.84, P = 0.00044), lower baseline LVEF (OR per 1% 1.09; 95% CI 1.04-1.14, P = 0.00034). During the median follow-up of 3.2 years, LV systolic dysfunction recovered among 33 patients (67.3%) with a median time of 4 months (IQR 2-6 months), which was independently associated with the introduction of standard medical treatment for HF (OR 9.39; 95% CI 2.27-52.9, P = 0.0014) by multivariate analysis. Early initiation of standard medical treatment for HF may lead to LV functional recovery in AIC.
Sections du résumé
BACKGROUND
BACKGROUND
Left ventricular (LV) dysfunction due to anthracycline-induced cardiotoxicity (AIC) has been believed to be irreversible. However, this has not been confirmed and standard medical treatment for heart failure (HF) including renin-angiotensin inhibitors and β-blockers may lead to its recovery.
METHODS AND RESULTS
RESULTS
We thus retrospectively studied 350 cancer patients receiving anthracycline-based chemotherapy from 2001 to 2015 in our institution. Fifty-two patients (14.9%) developed AIC with a decrease in LV ejection fraction (LVEF) of 24.1% at a median time of 6 months [interquartile range (IQR) 4-22 months] after anthracycline therapy. By multivariate analysis, AIC was independently associated with cardiac comorbidities including ischemic heart disease, valvular heart disease, arrhythmia, and cardiomyopathy [odds ratio (OR) 6.00; 95% confidence interval (CI) 2.27-15.84, P = 0.00044), lower baseline LVEF (OR per 1% 1.09; 95% CI 1.04-1.14, P = 0.00034). During the median follow-up of 3.2 years, LV systolic dysfunction recovered among 33 patients (67.3%) with a median time of 4 months (IQR 2-6 months), which was independently associated with the introduction of standard medical treatment for HF (OR 9.39; 95% CI 2.27-52.9, P = 0.0014) by multivariate analysis.
CONCLUSION
CONCLUSIONS
Early initiation of standard medical treatment for HF may lead to LV functional recovery in AIC.
Identifiants
pubmed: 30367208
doi: 10.1007/s00392-018-1386-0
pii: 10.1007/s00392-018-1386-0
doi:
Substances chimiques
Anthracyclines
0
Antibiotics, Antineoplastic
0
Cardiovascular Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
600-611Subventions
Organisme : Grant-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science, and Technology of Japan
ID : 16K09442
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