Early- and late anthracycline-induced cardiac dysfunction: echocardiographic characterization and response to heart failure therapy

Bibliographic Details
Title: Early- and late anthracycline-induced cardiac dysfunction: echocardiographic characterization and response to heart failure therapy
Authors: Janine A. M. Kamphuis, Marijke Linschoten, Maarten J. Cramer, Pieter A. Doevendans, Folkert W. Asselbergs, Arco J. Teske
Source: Cardio-Oncology, Vol 6, Iss 1, Pp 1-13 (2020)
Publisher Information: BMC, 2020.
Publication Year: 2020
Collection: LCC:Diseases of the circulatory (Cardiovascular) system
LCC:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Subject Terms: Heart failure, Anthracyclines, Cardiac dysfunction, Cardiac effects of cancer treatment, Diseases of the circulatory (Cardiovascular) system, RC666-701, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
More Details: Abstract Background Anthracycline-induced cardiac dysfunction (ACD) is a notorious side effect of anticancer treatment. It has been described as a phenomenon of a continuous progressive decline of cardiac function, eventually leading to dilated cardiomyopathy (DCM). This progressive nature suggests that patients with a delayed ACD diagnosis have greater compromise of cardiac function and more adverse remodeling, with a poor response to heart failure (HF) treatment. This study aimed to delineate the impact of a delayed ACD diagnosis on echocardiographic characteristics and response to HF treatment. Methods and results From the population of our cardio-oncology outpatient clinic, 92 ACD patients were included in this study (age 51.6 ± 16.2 years, median cumulative anthracycline dose 329 [200–329] mg/m2), and a median follow-up of 25.0 [9.6–37.2] months after ACD diagnosis. Median time to ACD diagnosis for patients diagnosed early ( 1 year) was 4.0 vs. 47.7 months respectively. There were no echocardiographic differences between patients diagnosed early vs. late (LVEF 43.6 ± 4.9% vs. 43.0 ± 6.2% and iEDV 63.6 vs. 62.9 mL/m2). Eighty-three percent of patients presented with mild LV dysfunction and in 79% the LV was not dilated. Patients diagnosed early were more likely to have (partial) recovery of cardiac function upon HF treatment initiation (p = 0.015). Conclusions In the setting of a cardio-oncology outpatient clinic, patients with ACD presented with a hypokinetic non-dilated cardiomyopathy, rather than typical DCM. Timing of ACD diagnosis did not impact HF disease severity. However, in patients receiving an early diagnosis, cardiac function was more likely to recover upon HF treatment.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2057-3804
Relation: http://link.springer.com/article/10.1186/s40959-020-00079-3; https://doaj.org/toc/2057-3804
DOI: 10.1186/s40959-020-00079-3
Access URL: https://doaj.org/article/1b9e2d04da7548c5bdebda7c26652863
Accession Number: edsdoj.1b9e2d04da7548c5bdebda7c26652863
Database: Directory of Open Access Journals
More Details
ISSN:20573804
DOI:10.1186/s40959-020-00079-3
Published in:Cardio-Oncology
Language:English