Cardiac Therapy Improves Heart Function in Patients With Chemotherapy-Induced Events

Rachel Narozniak, MA
Published: Saturday, Jan 04, 2020
Cardiac resynchronization therapy (CRT) improved heart function in patients who developed chemotherapy-induced cardiomyopathy (CHIC), according to findings from a small study published in JAMA. At a 6-month follow-up, 24 of 26 patients (83%) had either no symptoms or mild symptoms of heart failure after CRT.

CHIC is a progressive weakening of the heart muscle that can present in patients treated with chemotherapy, and has specifically been linked to anthracyclines. Patients with CHIC are known to develop heart failure months or even years after undergoing chemotherapy; however, most patients show signs of cardiac dysfunction within the first year of treatment. Progressive heart failure and mortality rates can be as high as 50% within 2 years of diagnosis, authors said.

The MADIT-CHIC trial (NCT02164721) evaluated CRT in 30 patients with CHIC. Its primary end point was change in left ventricular ejection fraction (LVEF) from baseline to 6 months after initiating CRT. Results showed that patients with CRT experienced a statistically significant improvement in mean LVEF at 6 months. Specifically, LVEF rose from 28% to 39% (difference, 10.6% [95% CI, 8.0%-13.3%]; P <.001).

CRT also led to a reduction in left ventricular (LV) end-systolic volume, which decreased from 122.7 mL to 89.0 mL (difference, 37.0 mL [95% CI, 28.2-45.8, P <.001]). LV end-diastolic volume dropped from 171.0 mL to 143.2 mL (difference, 31.9 mL [95% CI, 22.1-41.6, P <.001]; Table).

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