Factors associated with the recovery of chemotherapy induced cardiomyopathy in HER2 overexpressing breast cancer

Abstract

Objective: Chemotherapy induced cardiomyopathy (CI-CMP) is an important and potentially deadly complication of chemotherapy. However, factors associated with the recovery of CI-CMP have not been studied adequately so far. In this study, determinants of the recovery of CI-CMP in HER2 overexpressing breast cancer patients who received a chemotherapy regimen consisting of Doxorubicin, Trastuzumab, Paclitaxel and Cyclophosphamide and developed CI-CMP were investigated. Material and Methods: 88 patients with CI-CMP among 1.410 HER2 positive breast cancer patients were enrolled and followed up for a median of 64 months. A multivariate logistic regression analysis model was used to assess the association between recovery of CI-CMP and other variables Results: The median age of the participants was 52, and similar between groups. CI-CMP was recovered in 52 patients (59.1 %). Hypertension, diabetes mellitus, clinical heart failure, ECG anomaly, visceral metastasis, heart rate and blood glucose were significantly lower in recovered patients. A multivariate logistic regression analysis revealed that diabetes mellitus (OR 0.030, CI 0.010-0.083, p<0.001), heart rate (OR 0.799, CI 0.700-0.913, p<0.001), minimum LVEF during follow-up (OR 1.115, CI 1.015-1.223, p=0.03), development of clinical heart failure (OR 0.238, CI 0.098-0.876, p=0.022) and visceral metastasis (OR 0.022, CI 0.002-0.226, p=0.001) were independent predictors of the recovery of CI-CMP. Conclusion: According to our results, Diabetes mellitus, heart rate, minimum LVEF during follow-up, development of clinical heart failure, and presence of visceral metastasis were independently associated with the recovery of CI-CMP. Particularly, relationship between diabetes and recovery of CI-CMP is notable and deserves further research.