Abstract 12766: Early and Persistent Evidence of Subclinical Cardiovascular Injury after Receipt of Anthracycline Chemotherapy.
Purpose: To determine the time-dependent association of anthracycline chemotherapy with noninvasive measures of subclinical cardiovascular (CV) disease.
Patients and Methods: We performed a prospective, cohort study (NIH-R33CA12196) involving 51 patients scheduled to receive 3 to 4 months of doxorubicin or daunorubicin for the treatment of breast cancer, leukemia, and lymphoma. All patients underwent cardiac magnetic resonance imaging (CMR) measures of left ventricular (LV) volumes, LV ejection fraction (LVEF), LV strain, pulse wave velocity in the thoracic aorta, as well as heart failure questionnaires pre-chemotherapy and at 1, 3, and 8 months after initiation. All analyses were performed by personnel blinded to identifiers, treatment, and other aspects of the analyses.
Results: Average age of participants was 52 years (range 19–81), 63% were women, and 24% were black or hispanic. Chemotherapy for breast cancer was administered in 37% of participants with the remainder treated for leukemia or lymphoma. An adverse effect on subclinical markers of cardiovascular disease was evident at 1 month that was not present at baseline (table 1). The adverse change in sub-clinical markers of cardiovascular disease persisted 2–4 months after cessation of anthracyclines (8 months after treatment initiation or baseline) (table 1). The most significant changes were in pulse wave velocity. All changes persisted after adjustment for age, gender, and race.
Conclusions: Early after receipt of anthracycline chemotherapy for breast or hematologic malignancy, patients develop subclinical abnormalities of CV function that persist 2 to 4 months after discontinuation of therapy. These findings have implications for identification of mechanisms of CV events in cancer survivors. *Analyses/p-values based on results from repeated measures mixed models analysis of variance with patient as random effect and age, gender and race included as covariates.
- © 2010 by American Heart Association, Inc.