Maya E. Guglin, MD, PhD
University of Kentucky College of Medicine
Chemotherapy can cause multiple cardiac adverse effects (AEs), including proarrhythmia, coronary spasm resulting in acute myocardial infarction, and QT prolongation. But no other AE has attracted as much attention, discussion, studies, or resources as chemotherapy-induced cardiomyopathy, which can be either a silent decrease in left ventricular ejection fraction (LVEF) or an overt clinical syndrome of fluid retention due to decreased cardiac output, also known as heart failure (HF). In the most severe cases, the condition can lead to a substantial and irreversible decrease in LVEF, perhaps requiring cardiac transplantation or mechanical circulatory support. What an unfortunate conundrum for oncologists, who might be able to save a patient from cancer only to leave that person with a lifelong cardiac deficit!
Supportive Therapy Explored
The results of several small studies suggest that adding angiotensin converting enzyme (ACE) inhibitors and/or beta-blockers to a chemotherapy regimen for patients with breast cancer could limit heart damage. Investigators at the University of Kentucky in Lexington and colleagues set out to explore the hypothesis on a larger scale.
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