Frequency of Transition From Stage A to Stage B Heart Failure After Initiating Potentially Cardiotoxic Chemotherapy

Area of Science:

• Cardiology
• Oncology
• Cardio-oncology

Background:

• The progression of heart failure (HF) stages following cardiotoxic chemotherapy is not well understood.
• Cancer patients receiving cardiotoxic chemotherapy are at risk for developing or worsening HF.

Purpose of the Study:

• To determine the prevalence of American Heart Association/American College of Cardiology Foundation (AHA/ACCF) heart failure (HF) stages after initiating potentially cardiotoxic chemotherapy.
• To assess the relationship between early HF stage changes and long-term HF status.

Main Methods:

• 143 patients with Stage A HF and various cancers (breast, lymphoma, leukemia, renal cell carcinoma, sarcoma) were monitored.
• Cardiac magnetic resonance imaging (MRI) was used to measure left ventricular ejection fraction (LVEF) at baseline and at 3, 6, and 12 to 24 months post-chemotherapy.

Main Results:

• Within 3 months of chemotherapy initiation, 18.9% of patients progressed from Stage A to Stage B HF.
• At 3 months, 83% of Stage A HF patients remained Stage A at 6 months and 80% at 12-24 months.
• Of those with Stage B HF at 3 months, 68% remained Stage B at 6 months and 56% at 12-24 months.

Conclusions:

• Early HF stage transition (Stage A to B) or persistence at 3 months post-chemotherapy is linked to longer-term HF stage assessments.
• These findings highlight the importance of monitoring HF stages in cancer patients undergoing cardiotoxic treatment.