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

Kisho Ohtani, Takeo Fujino, Tomomi Ide, Kouta Funakoshi, Ichirou Sakamoto, Hiasa Ken-Ichi, Taiki Higo, Kenjiro Kamezaki, Koichi Akashi, Hiroyuki Tsutsui

Research output: Contribution to journalArticle

Abstract

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: 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: Early initiation of standard medical treatment for HF may lead to LV functional recovery in AIC.

Original languageEnglish
Pages (from-to)600-611
Number of pages12
JournalClinical Research in Cardiology
Volume108
Issue number6
DOIs
Publication statusPublished - Jun 1 2019

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Anthracyclines
Left Ventricular Dysfunction
Heart Failure
Treatment Failure
Neoplasms
Odds Ratio
Confidence Intervals
Therapeutics
Multivariate Analysis
Heart Valve Diseases
Cardiomyopathies
Stroke Volume
Myocardial Ischemia
Cardiotoxicity
Comorbidity
Cardiac Arrhythmias
Drug Therapy

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

@article{180096e230ec4ab5a6fa5d1d6d1e9d69,
title = "Recovery from left ventricular dysfunction was associated with the early introduction of heart failure medical treatment in cancer patients with anthracycline-induced cardiotoxicity",
abstract = "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: 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: Early initiation of standard medical treatment for HF may lead to LV functional recovery in AIC.",
author = "Kisho Ohtani and Takeo Fujino and Tomomi Ide and Kouta Funakoshi and Ichirou Sakamoto and Hiasa Ken-Ichi and Taiki Higo and Kenjiro Kamezaki and Koichi Akashi and Hiroyuki Tsutsui",
year = "2019",
month = "6",
day = "1",
doi = "10.1007/s00392-018-1386-0",
language = "English",
volume = "108",
pages = "600--611",
journal = "Clinical Research in Cardiology",
issn = "1861-0684",
publisher = "D. Steinkopff-Verlag",
number = "6",

}

TY - JOUR

T1 - Recovery from left ventricular dysfunction was associated with the early introduction of heart failure medical treatment in cancer patients with anthracycline-induced cardiotoxicity

AU - Ohtani, Kisho

AU - Fujino, Takeo

AU - Ide, Tomomi

AU - Funakoshi, Kouta

AU - Sakamoto, Ichirou

AU - Ken-Ichi, Hiasa

AU - Higo, Taiki

AU - Kamezaki, Kenjiro

AU - Akashi, Koichi

AU - Tsutsui, Hiroyuki

PY - 2019/6/1

Y1 - 2019/6/1

N2 - 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: 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: Early initiation of standard medical treatment for HF may lead to LV functional recovery in AIC.

AB - 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: 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: Early initiation of standard medical treatment for HF may lead to LV functional recovery in AIC.

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U2 - 10.1007/s00392-018-1386-0

DO - 10.1007/s00392-018-1386-0

M3 - Article

VL - 108

SP - 600

EP - 611

JO - Clinical Research in Cardiology

JF - Clinical Research in Cardiology

SN - 1861-0684

IS - 6

ER -