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Recovery from left ventricular dysfunction was associated with the early introduction of heart failure medical treatment in cancer patients with anthracycline-induced cardiotoxicity

Authors
  • Ohtani, Kisho
  • Fujino, Takeo
  • Ide, Tomomi
  • Funakoshi, Kouta
  • Sakamoto, Ichirou
  • Hiasa, Ken-ichi
  • Higo, Taiki
  • Kamezaki, Kenjiro
  • Akashi, Koichi
  • Tsutsui, Hiroyuki
Type
Published Article
Journal
Clinical Research in Cardiology
Publisher
Springer Berlin Heidelberg
Publication Date
Oct 26, 2018
Volume
108
Issue
6
Pages
600–611
Identifiers
DOI: 10.1007/s00392-018-1386-0
Source
Springer Nature
Keywords
License
Yellow

Abstract

BackgroundLeft 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 resultsWe 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.ConclusionEarly initiation of standard medical treatment for HF may lead to LV functional recovery in AIC.

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