Author + information
- Deanna Jones,
- Cynthia Suerken,
- Ralph D'Agostino,
- Giselle Melendez,
- Jennifer Jordan and
- W. Hundley
Background: Cardiotoxicity leading to clinical heart failure is a known complication of anthracycline and other chemotherapeutic agents. Though the prevalence of clinically decompensated heart failure in individuals after chemotherapy has been studied, to our knowledge, the frequency of transition from Stage A to B or C heart failure following initiation of potentially cardiotoxic chemotherapy is not well known.
Methods: In 143 cancer patients at risk for heart failure (Stage A) scheduled to receive potentially cardiotoxic chemotherapy, we obtained baseline demographic information, Minnesota Living with Heart Failure Questionnaire (MLHFQ) scores, focusing specifically on heart failure symptoms, and left ventricular ejection fraction (LVEF) using cardiac magnetic resonance (CMR) imaging, analyzed by blinded readers. Three months later, the patients underwent repeat CMR imaging to assess LVEF and repeated the MLHFQ. Patients were assigned Stage A-D heart failure at the three month visit based on LVEF and MLFHQ score change. Statistical analyses were performed using Chi square, Fisher's Exact, and two sample t tests.
Results: Three months after initiating potentially cardiotoxic chemotherapy, 18.9% of participants transitioned to either Stage B (16.8%) or C (2.1%) heart failure, and average LVEF changed from 60.5 ± 0.5% to 56.7 ± 0.6% (p < 0.001). Participants previously treated with anthracycline-based chemotherapy regimens (p = 0.012) or who received anthracycline followed by trastuzumab (p = 0.024) were more likely to progress to Stage B or C heart failure. Patients with acute myelogenous leukemia developed Stage B or C heart failure more often (p = 0.004). Cumulative doses of chemotherapy drugs, including anthracyclines, cardiovascular risk factors, age, or other medical comorbidities were not associated with progression from Stage A to B or C heart failure.
Conclusions: One fifth of individuals receiving potentially cardiotoxic chemotherapy transitioned from Stage A to B or C heart failure three months after initiation of chemotherapy. Longitudinal studies are necessary to determine if these transitions are permanent upon completion of chemotherapy.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: The Evolving World of LVADs, Transplant and Other Novel Discoveries
Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical
Presentation Number: 1294-257
- 2017 American College of Cardiology Foundation