In This Article
- Patients with chemotherapy-induced cardiomyopathy have a two-year survival rate lower than 50%, but are underrepresented in clinical trials
- In the first study of its kind, 30 patients with chemotherapy-induced cardiomyopathy were implanted with a cardiac resynchronization therapy (CRT) device and underwent echocardiography at six months
- CRT improved left ventricular function and promoted reverse remodeling
- Left ventrical ejection fraction improved a mean of 10.6%
Patients with chemotherapy-induced cardiomyopathy saw improved left ventricular function after receiving cardiac resynchronization therapy (CRT), according to a recent study by Jagmeet Singh, MD, PHD, associate chief of the Cardiology Division at Massachusetts General Hospital, and colleagues.
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Dr. Singh explains that the chemotherapy-induced cardiomyopathy patient population had been underrepresented in randomized clinical trials, even though CRT has existed for several decades. These patients present with HF and have a two-year survival rate lower than 50%.
The MADIT-CHIC study analyzed the left ventricle ejection fraction of 30 patients with chemotherapy-induced cardiomyopathy six months after being implanted with a CRT device. The patients had been treated for breast cancer (73%), lymphoma (20%) or sarcoma (7%), and most had been treated with anthracyclines. The mean age was 64 years and 87% were women.
Echocardiograms showed evidence that reverse remodeling had occurred, and patients saw a mean of 10.6% improvement in LVEF. The results were consistent across sex, age, NYHA class, QRS and baseline LVEF. Other measures also decreased, including LV end-systolic volume, LV end-diastolic volume, LV mass and left atrial volume.
Dr. Singh notes that the patients in this population would benefit from more integrated cardiology and oncology care to better understand the molecular basis of chemotherapy and heart failure. While reverse remodeling often predicts long-term effects, Dr. Singh recommends further study to track patient outcomes.
Refer a patient to the Mass General Heart Center
Learn more about cardiac resynchronization therapy at Mass General