Factors Associated With the Recovery of Left Ventricular Ejection Fraction in Patients With Anthracycline-Induced Left Ventricular Dysfunction
Background Neurohormonal blocking drugs, like beta-blockers, angiotensin-converting enzyme inhibitors (ACEIs), and angiotensin receptor blockers (ARBs), are recommended for treating anthracycline-induced left ventricular dysfunction (AILVD). However, there is limited evidence supporting their benefi...
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| Format: | Article |
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SAGE Publishing
2025-01-01
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| Series: | Journal of Cardiovascular Pharmacology and Therapeutics |
| Online Access: | https://doi.org/10.1177/10742484241304304 |
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| author | Tyler Shugg PharmD, PhD Tk Nguyen PharmD Xuesi Hua BS Blair Richards MPH James Rae PhD Robert Dess MD Daniel Perry MD Bradley Kay MD Salim S. Hayek MD Monika Leja MD Jasmine A. Luzum PharmD, PhD |
| author_facet | Tyler Shugg PharmD, PhD Tk Nguyen PharmD Xuesi Hua BS Blair Richards MPH James Rae PhD Robert Dess MD Daniel Perry MD Bradley Kay MD Salim S. Hayek MD Monika Leja MD Jasmine A. Luzum PharmD, PhD |
| author_sort | Tyler Shugg PharmD, PhD |
| collection | DOAJ |
| description | Background Neurohormonal blocking drugs, like beta-blockers, angiotensin-converting enzyme inhibitors (ACEIs), and angiotensin receptor blockers (ARBs), are recommended for treating anthracycline-induced left ventricular dysfunction (AILVD). However, there is limited evidence supporting their benefit. Therefore, this study evaluated associations of neurohormonal blockers and other clinical factors with recovery of left ventricular ejection fraction (LVEF) in patients with AILVD. Methods This retrospective chart review assessed patients treated with at least one dose of anthracycline, then had ≥10% LVEF reduction or post-anthracycline LVEF value <50%, and then had a follow-up LVEF measurement ≥90 days later. The primary endpoint was LVEF recovery (highest follow-up LVEF−lowest LVEF post-anthracycline). Variables from univariable tests with P < .1 were incorporated in a multiple linear regression model for independent factors significantly associated with LVEF recovery ( P < .05). Results Out of 104 patients, 83% were female, 86% self-reported white race, 53% had breast cancer, median (IQR) age was 52 (22) years, and LVEF recovery was 14% (16%). The final multivariable model included 2 significant variables: beta-blocker dose after anthracycline exposure (every 25 mg increase in beta-blocker dose was associated with 5.0% increase in LVEF recovery; P = .0005) and the time between the start of the anthracycline and the lowest LVEF post-anthracycline (every 5-year increase in time was associated with 1.8% decrease in LVEF recovery; P = .0379). Conclusions In patients with AILVD, a higher beta-blocker dose and earlier detection of LVEF reduction post-anthracycline were significantly and independently associated with improved LVEF recovery. These findings need to be validated in a larger, independent cohort. |
| format | Article |
| id | doaj-art-5ac713272d4e45fa9e2bdaeae663b6b9 |
| institution | Kabale University |
| issn | 1940-4034 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Cardiovascular Pharmacology and Therapeutics |
| spelling | doaj-art-5ac713272d4e45fa9e2bdaeae663b6b92025-01-13T09:03:22ZengSAGE PublishingJournal of Cardiovascular Pharmacology and Therapeutics1940-40342025-01-013010.1177/10742484241304304Factors Associated With the Recovery of Left Ventricular Ejection Fraction in Patients With Anthracycline-Induced Left Ventricular DysfunctionTyler Shugg PharmD, PhD0Tk Nguyen PharmD1Xuesi Hua BS2Blair Richards MPH3James Rae PhD4Robert Dess MD5Daniel Perry MD6Bradley Kay MD7Salim S. Hayek MD8Monika Leja MD9Jasmine A. Luzum PharmD, PhD10 Department of Clinical Pharmacy, , Ann Arbor, MI, USA Department of Clinical Pharmacy, , Ann Arbor, MI, USA Department of Clinical Pharmacy, , Ann Arbor, MI, USA Michigan Institute for Clinical & Health Research (MICHR), University of Michigan, Ann Arbor, MI, USA Department of Internal Medicine, Division of Hematology and Oncology, , Ann Arbor, MI, USA Department of Radiation Oncology, , Ann Arbor, MI, USA Division of Cardiovascular Medicine, Department of Internal Medicine, Michigan Medicine, Ann Arbor, MI, USA Department of Cardiology, , New Haven, CT, USA Division of Cardiovascular Medicine, Department of Internal Medicine, Michigan Medicine, Ann Arbor, MI, USA Division of Cardiovascular Medicine, Department of Internal Medicine, Michigan Medicine, Ann Arbor, MI, USA Department of Clinical Pharmacy, , Ann Arbor, MI, USABackground Neurohormonal blocking drugs, like beta-blockers, angiotensin-converting enzyme inhibitors (ACEIs), and angiotensin receptor blockers (ARBs), are recommended for treating anthracycline-induced left ventricular dysfunction (AILVD). However, there is limited evidence supporting their benefit. Therefore, this study evaluated associations of neurohormonal blockers and other clinical factors with recovery of left ventricular ejection fraction (LVEF) in patients with AILVD. Methods This retrospective chart review assessed patients treated with at least one dose of anthracycline, then had ≥10% LVEF reduction or post-anthracycline LVEF value <50%, and then had a follow-up LVEF measurement ≥90 days later. The primary endpoint was LVEF recovery (highest follow-up LVEF−lowest LVEF post-anthracycline). Variables from univariable tests with P < .1 were incorporated in a multiple linear regression model for independent factors significantly associated with LVEF recovery ( P < .05). Results Out of 104 patients, 83% were female, 86% self-reported white race, 53% had breast cancer, median (IQR) age was 52 (22) years, and LVEF recovery was 14% (16%). The final multivariable model included 2 significant variables: beta-blocker dose after anthracycline exposure (every 25 mg increase in beta-blocker dose was associated with 5.0% increase in LVEF recovery; P = .0005) and the time between the start of the anthracycline and the lowest LVEF post-anthracycline (every 5-year increase in time was associated with 1.8% decrease in LVEF recovery; P = .0379). Conclusions In patients with AILVD, a higher beta-blocker dose and earlier detection of LVEF reduction post-anthracycline were significantly and independently associated with improved LVEF recovery. These findings need to be validated in a larger, independent cohort.https://doi.org/10.1177/10742484241304304 |
| spellingShingle | Tyler Shugg PharmD, PhD Tk Nguyen PharmD Xuesi Hua BS Blair Richards MPH James Rae PhD Robert Dess MD Daniel Perry MD Bradley Kay MD Salim S. Hayek MD Monika Leja MD Jasmine A. Luzum PharmD, PhD Factors Associated With the Recovery of Left Ventricular Ejection Fraction in Patients With Anthracycline-Induced Left Ventricular Dysfunction Journal of Cardiovascular Pharmacology and Therapeutics |
| title | Factors Associated With the Recovery
of Left Ventricular Ejection Fraction in
Patients With Anthracycline-Induced Left Ventricular Dysfunction |
| title_full | Factors Associated With the Recovery
of Left Ventricular Ejection Fraction in
Patients With Anthracycline-Induced Left Ventricular Dysfunction |
| title_fullStr | Factors Associated With the Recovery
of Left Ventricular Ejection Fraction in
Patients With Anthracycline-Induced Left Ventricular Dysfunction |
| title_full_unstemmed | Factors Associated With the Recovery
of Left Ventricular Ejection Fraction in
Patients With Anthracycline-Induced Left Ventricular Dysfunction |
| title_short | Factors Associated With the Recovery
of Left Ventricular Ejection Fraction in
Patients With Anthracycline-Induced Left Ventricular Dysfunction |
| title_sort | factors associated with the recovery of left ventricular ejection fraction in patients with anthracycline induced left ventricular dysfunction |
| url | https://doi.org/10.1177/10742484241304304 |
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