Clinical, Echocardiographic and Laboratory Cardiac Monitoring in Breast Cancer Patients Undergoing Chemotherapy with Anthracycline Agents: A Pilot Study on Cardioprotective Algorithms at Mohammad Hoesin General Hospital, Palembang

Objectives We analyzed echocardiography and laboratory results of breast cancer patients undergoing chemotherapy with anthracycline agents, to find cardiotoxicity risk and prevalence among South Sumatra population.     Background Improved cancer therapy and early disease detection, increase t...

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Main Author: Indah Puspita
Format: Article
Language:English
Published: Indonesian Heart Association 2025-07-01
Series:Majalah Kardiologi Indonesia
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Online Access:https://www.ijconline.id/index.php/ijc/article/view/1772
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author Indah Puspita
author_facet Indah Puspita
author_sort Indah Puspita
collection DOAJ
description Objectives We analyzed echocardiography and laboratory results of breast cancer patients undergoing chemotherapy with anthracycline agents, to find cardiotoxicity risk and prevalence among South Sumatra population.     Background Improved cancer therapy and early disease detection, increase the survival rate, also increase risk of CTRCD, range between 2 and 48% for patient with breast cancer treated by anthracyclines. There was limited data about prevalence of CTRCD in South Sumatra. Study of demographic factors and potential laboratory cardiac marker in specific population will give others additional important information.   Methods In 2024, from March until November, 30 breast cancer patients were included in this analysis. Age 51,50 (41-69) years. All patients were in anthracycline chemotherapy treatment in Mohammad Hoesin General Hospital. Data of demography, laboratory and echocardiography was collected at baseline and after 3 cycles of treatment.   Results Data collection and analysis was processed in outpatient department of Brain and Heart Installation Mohammad Hoesin General Hospital. From 30 patient, cardiovascular risk factors was detected: hypertension 30%, diabetes 10%, dyslipidemia 13,3%, body mass index 23,32 (13,30- 31,18), and almost all patients were not smoker (96,7%). Baseline to serial echocardiography showed that anthracycline did not affect the decrease of left ventricular ejection fraction (LVEF) (p=0,212), but correlated with the decrease of left ventricle global longitudinal strain (GLS) (p<0,05). There were 16 patients with >15% global longitudinal strain (GLS) reduction, without significant clinical heart failure signs and symptoms, known as mild asymptomatic cancer-therapy related cardiac dysfunction (CTRCD). Laboratory examination showed anthracycline agent was not correlated with Troponin T (p=0,093), NT-pro BNP (p=0,150), Serum Iron (p= 0,775), Total Iron Binding Capacity (TIBC) (p=0,692) and Transferrin Saturation (p=0,748).  Ferritin level was affected by anthracycline agents (p= 0,026).   Conclusion Higher prevalence of CTRCD in South Sumatra population was found. There was low incidence of cardiovascular risk factors in this population, indicated stronger isolated effect of chemotherapy agent for cardiac dysfunction progression. GLS by echocardiography measurement remain to be a good marker for cardiotoxicity related anthracycline agents. Ferritin level is potential parameter in guiding the stages and strategies in cancer treatment.   Keywords: anthracycline, cardiac dysfunction, global longitudinal strain, ferritin
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spelling doaj-art-91c7f6f69d4946eeaea69a3b47ca4c5e2025-08-20T03:43:21ZengIndonesian Heart AssociationMajalah Kardiologi Indonesia0126-37732620-47622025-07-0146110.30701/ijc.1772Clinical, Echocardiographic and Laboratory Cardiac Monitoring in Breast Cancer Patients Undergoing Chemotherapy with Anthracycline Agents: A Pilot Study on Cardioprotective Algorithms at Mohammad Hoesin General Hospital, PalembangIndah Puspita0Mohammad Hoesin General Hospital Objectives We analyzed echocardiography and laboratory results of breast cancer patients undergoing chemotherapy with anthracycline agents, to find cardiotoxicity risk and prevalence among South Sumatra population.     Background Improved cancer therapy and early disease detection, increase the survival rate, also increase risk of CTRCD, range between 2 and 48% for patient with breast cancer treated by anthracyclines. There was limited data about prevalence of CTRCD in South Sumatra. Study of demographic factors and potential laboratory cardiac marker in specific population will give others additional important information.   Methods In 2024, from March until November, 30 breast cancer patients were included in this analysis. Age 51,50 (41-69) years. All patients were in anthracycline chemotherapy treatment in Mohammad Hoesin General Hospital. Data of demography, laboratory and echocardiography was collected at baseline and after 3 cycles of treatment.   Results Data collection and analysis was processed in outpatient department of Brain and Heart Installation Mohammad Hoesin General Hospital. From 30 patient, cardiovascular risk factors was detected: hypertension 30%, diabetes 10%, dyslipidemia 13,3%, body mass index 23,32 (13,30- 31,18), and almost all patients were not smoker (96,7%). Baseline to serial echocardiography showed that anthracycline did not affect the decrease of left ventricular ejection fraction (LVEF) (p=0,212), but correlated with the decrease of left ventricle global longitudinal strain (GLS) (p<0,05). There were 16 patients with >15% global longitudinal strain (GLS) reduction, without significant clinical heart failure signs and symptoms, known as mild asymptomatic cancer-therapy related cardiac dysfunction (CTRCD). Laboratory examination showed anthracycline agent was not correlated with Troponin T (p=0,093), NT-pro BNP (p=0,150), Serum Iron (p= 0,775), Total Iron Binding Capacity (TIBC) (p=0,692) and Transferrin Saturation (p=0,748).  Ferritin level was affected by anthracycline agents (p= 0,026).   Conclusion Higher prevalence of CTRCD in South Sumatra population was found. There was low incidence of cardiovascular risk factors in this population, indicated stronger isolated effect of chemotherapy agent for cardiac dysfunction progression. GLS by echocardiography measurement remain to be a good marker for cardiotoxicity related anthracycline agents. Ferritin level is potential parameter in guiding the stages and strategies in cancer treatment.   Keywords: anthracycline, cardiac dysfunction, global longitudinal strain, ferritin https://www.ijconline.id/index.php/ijc/article/view/1772anthracycline, cardiac dysfunction, global longitudinal strain, ferritin
spellingShingle Indah Puspita
Clinical, Echocardiographic and Laboratory Cardiac Monitoring in Breast Cancer Patients Undergoing Chemotherapy with Anthracycline Agents: A Pilot Study on Cardioprotective Algorithms at Mohammad Hoesin General Hospital, Palembang
Majalah Kardiologi Indonesia
anthracycline, cardiac dysfunction, global longitudinal strain, ferritin
title Clinical, Echocardiographic and Laboratory Cardiac Monitoring in Breast Cancer Patients Undergoing Chemotherapy with Anthracycline Agents: A Pilot Study on Cardioprotective Algorithms at Mohammad Hoesin General Hospital, Palembang
title_full Clinical, Echocardiographic and Laboratory Cardiac Monitoring in Breast Cancer Patients Undergoing Chemotherapy with Anthracycline Agents: A Pilot Study on Cardioprotective Algorithms at Mohammad Hoesin General Hospital, Palembang
title_fullStr Clinical, Echocardiographic and Laboratory Cardiac Monitoring in Breast Cancer Patients Undergoing Chemotherapy with Anthracycline Agents: A Pilot Study on Cardioprotective Algorithms at Mohammad Hoesin General Hospital, Palembang
title_full_unstemmed Clinical, Echocardiographic and Laboratory Cardiac Monitoring in Breast Cancer Patients Undergoing Chemotherapy with Anthracycline Agents: A Pilot Study on Cardioprotective Algorithms at Mohammad Hoesin General Hospital, Palembang
title_short Clinical, Echocardiographic and Laboratory Cardiac Monitoring in Breast Cancer Patients Undergoing Chemotherapy with Anthracycline Agents: A Pilot Study on Cardioprotective Algorithms at Mohammad Hoesin General Hospital, Palembang
title_sort clinical echocardiographic and laboratory cardiac monitoring in breast cancer patients undergoing chemotherapy with anthracycline agents a pilot study on cardioprotective algorithms at mohammad hoesin general hospital palembang
topic anthracycline, cardiac dysfunction, global longitudinal strain, ferritin
url https://www.ijconline.id/index.php/ijc/article/view/1772
work_keys_str_mv AT indahpuspita clinicalechocardiographicandlaboratorycardiacmonitoringinbreastcancerpatientsundergoingchemotherapywithanthracyclineagentsapilotstudyoncardioprotectivealgorithmsatmohammadhoesingeneralhospitalpalembang