What question did this study set out to answer?

To understand the mechanisms of chemotherapy-induced heart failure and report a case of cardiac recovery.

January 10, 2026Cureus0 citationsOpen Access

Reversible Heart Failure After Anthracycline and Alkylating Agent Chemotherapy

AGAmresh GulGénérale de Santé ZKZahid KhanUniversity of South Wales

Key Result

Guideline-directed medical therapy improved left ventricular ejection fraction from 39% to 50-55% in a patient with chemotherapy-induced heart failure after 12 months.

Key Points

To understand the mechanisms of chemotherapy-induced heart failure and report a case of cardiac recovery.
Case report of a 41-year-old female with chemotherapy-induced cardiomyopathy.
Baseline echocardiogram assessed biventricular function before treatment.
Quantified left ventricular ejection fraction (LVEF) before and after chemotherapy and during follow-up.
Patient managed with guideline-directed medical therapy after diagnosis.
Patient's LVEF declined from normal to 39% after anthracycline-based chemotherapy.
At six-month follow-up, LVEF improved to 45%.
LVEF further improved to 50-55% at twelve-month follow-up, indicating cardiac recovery.

Structured PICO

Does guideline-directed medical therapy improve LVEF in a patient with chemotherapy-induced cardiomyopathy?

Population

n=1, 41-year-old Caucasian female, current smoker, with early-stage right breast cancer (invasive carcinoma, PR/ER positive, HER2 negative) who developed chemotherapy-induced cardiomyopathy (HFrEF, LVEF 39%) following anthracycline and alkylating agent chemotherapy.

Intervention

Guideline-directed medical therapy (GDMT) including ramipril 2.5 mg (later increased to 5 mg), dapagliflozin 10 mg, spironolactone 25 mg, and bisoprolol 2.5 mg (later increased to 5 mg).

Outcome

Improvement in left ventricular ejection fraction (LVEF) and resolution of symptomssurrogate

Prompt initiation of guideline-directed medical therapy can reverse anthracycline-induced cardiomyopathy and significantly improve left ventricular ejection fraction.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Cardiotoxicity, including chemotherapy-induced heart failure (HF), remains a significant and well-recognised complication in modern oncologic practice. As cancer therapies evolve, treatment-related comorbidities continue to pose persistent challenges to patient outcomes and long-term survivorship. Among these, cytostatic-induced cardiotoxicity is particularly concerning due to its multifactorial and complex pathophysiology, involving oxidative stress, mitochondrial dysfunction, and direct myocardial injury. A comprehensive understanding of these mechanisms is essential for developing targeted preventive strategies and evidence-based therapeutic interventions. We report a case of a 41-year-old Caucasian female who developed chemotherapy-induced cardiomyopathy, or heart failure with reduced ejection fraction (HFrEF), following treatment for right-sided breast cancer. Baseline echocardiogram showed normal biventricular function; however, her left ventricular ejection fraction (LVEF) declined to 39% following dual anthracycline-based chemotherapy, specifically doxorubicin and cyclophosphamide, for breast cancer. The patient was subsequently managed with guideline-directed medical therapy (GDMT). At six- and 12-month follow-up, her LVEF improved to 45% and 50-55%, respectively, demonstrating favourable cardiac recovery under optimised pharmacologic management.

Ask AI

Helpful

Bookmark

View Full Paper