What question did this study set out to answer?

To report a case of chemotherapy-induced heart failure with reduced ejection fraction following anthracycline and alkylating agent treatment and evaluate recovery under guideline-directed medical therapy.

January 10, 2026CureusOpen Access

Reversible Heart Failure After Anthracycline and Alkylating Agent Chemotherapy

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Key result

GDMT linked to ~16% LVEF improvement in a case of chemotherapy-induced heart failure.

Why the study?

Chemotherapy-induced heart failure remains a significant oncologic complication with complex pathophysiology, requiring better understanding to develop targeted preventive strategies and evidence-based therapeutic interventions.

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

Population

A 41-year-old female who developed HFrEF after chemotherapy for right-sided breast cancer

Design

Case report

Follow-up

12-month

Authors

AGAmresh GulGénérale de Santé ZKZahid KhanUniversity of South Wales

Discussion

Member takes

Implication

May support GDMT recovery in anthracycline cardiomyopathy; hypothesis-generating and requires prospective confirmation before practice change.

Key Points

To report a case of chemotherapy-induced heart failure with reduced ejection fraction following anthracycline and alkylating agent treatment and evaluate recovery under guideline-directed medical therapy.
Clinical evaluation of a 41-year-old female treated with adjuvant dose-dense doxorubicin and cyclophosphamide followed by paclitaxel for early-stage right breast cancer.
Cardiovascular assessment via serial transthoracic echocardiography, global longitudinal strain measurement, and initiation of guideline-directed medical therapy consisting of ramipril 2.5mg, dapagliflozin 10mg, spironolactone 25mg, and bisoprolol 2.5mg.
Left ventricular ejection fraction declined from a baseline of 64% to 39% following anthracycline-based chemotherapy, accompanied by an impaired global longitudinal strain of -16.9%.
Guideline-directed medical therapy led to left ventricular ejection fraction improvement to 45% at six-month follow-up and 50-55% at 12-month follow-up.

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.

Cite This Study

Gul et al. (2025) studied this question. 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.

synapsesocial.com/papers/6963222a91e05aa366cb8b25 https://doi.org/10.7759/cureus.99997

Topics

Heart transplantation Heart failure HFrEF treatment Heart failure hospitalization

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Implication

May support GDMT recovery in anthracycline cardiomyopathy; hypothesis-generating and requires prospective confirmation before practice change.

Reversible Heart Failure After Anthracycline and Alkylating Agent Chemotherapy

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Reversible Heart Failure After Anthracycline and Alkylating Agent Chemotherapy

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

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