Heart rate variability-based prediction of early cardiotoxicity in breast-cancer patients treated with anthracyclines and trastuzumab

• Published in: Cardio-oncology (London, England) England), 2024-05, Vol.10 (1), p.32-14, Article 32
• Main Authors: Luna-Alcala, Santiago, Espejel-Guzmán, Adrián, Lerma, Claudia, Leon, Paula, Guerra, Enrique C, Fernández, Jose Rodrigo Espinosa, Martinez-Dominguez, Pavel, Serrano-Roman, Javier, Cabello-Ganem, Aldo, Aparicio-Ortiz, Alexis D, Keirns, Candace, Lerma, Abel, Ana-Bayona, Maria Jose Santa, Espinola-Zavaleta, Nilda
• Format: Article
• Language: English
• Subjects: Anthracyclines; Biomarkers; Breast cancer; Cancer therapies; Cardiotoxicity; Chemotherapy; Disease; Drug dosages; Electrocardiography; Heart failure; Heart rate; Heart rate variability; Hypertension; Ischemia; Monoclonal antibodies; Nervous system; Parasympathetic; Physiology; Sympathetic; Targeted cancer therapy; Time series; Trastuzumab; Vital signs
• ISSN: 2057-3804; 2057-3804
• DOI: 10.1186/s40959-024-00236-y

Cardiotoxicity is a recognized complication in breast cancer (BC) patients undergoing chemotherapy with anthracyclines with or without trastuzumab. However, the prognostic value of heart rate variability (HRV) indexes for early cardiotoxicity development remains unknown. Fifty BC patients underwent TTE assessment before and three months after chemotherapy. HRV indexes were obtained from continuous electrocardiograms in supine position with spontaneous breathing, active standing, and supine position with controlled breathing. The magnitude of change (Δ) between supine-standing and supine-controlled breathing was calculated. Variables were compared using t-test or ANOVA. Cardiotoxicity predictive value was assessed by ROC curve analysis. A p value of