Unmasking hypertension effect to early cardiac dysfunction in breast cancer patients undergoing chemotherapy with anthracycline

Background Cancer therapy-related cardiac dysfunction (CTRCD), marked by a >15% reduction of left ventricle global longitudinal strain (GLS), was found in patient receiving anthracycline chemotherapy. The role of hypertension in increasing cardiotoxicity risk remains unclear. Purpose To analyze hypertension severity and CTRCD in breast cancer patients receiving anthracycline chemotherapy. Methods In 2024, from March until November, 22 breast cancer patients receiving anthracycline chemotherapy detected to have CTRCD, was included in this study. The data of blood pressure was collected and categorized based on ESC guideline. GLS was measured by echocardiography before and after the third cycle of chemotherapy. Multivariate analyses were performed to assess the relationship between hypertension severity and GLS reduction. Results The average age of 22 female patients was 48.95±1.83 years, with hypertension was the most common comorbidity (86.3%). Patients in this study have 3 categories of blood pressure; normal, elevated (pre-hypertension) and stage I hypertension. ANOVA showed a significant difference in GLS reduction among hypertension groups (F=6.37%, p=0.008). Significant GLS reduction was found the most in stage I hypertension; 10.445% ([95% CI, 2.64%-18.25%]; p=0.007), followed by patient with elevated blood pressure; 7.689% ([95% CI, 0.89%-14.49%]; p=0.024). Regression analysis revealed hypertension severity as a significant predictor of GLS reduction (R²=34.5%, p=0.001). Conclusion Hypertension severity have significant effect to early cardiac dysfunction in breast cancer patients receiving anthracycline chemotherapy. Risk of cardiac dysfunction was already increased in elevated (pre-hypertension) patients. Early blood pressure monitoring and management was essential to reduce the risk of cardiotoxicity.the ANOVA analysis the regression analysis