Key result
Anthracycline exposure can trigger severe dilated cardiomyopathy and HFrEF a decade after cancer treatment.
Why the study?
Anthracycline cardiotoxicity can present many years after treatment as dilated cardiomyopathy and heart failure, but late-onset cases are not well characterized.
Case Report (n=1)
This case emphasizes the potential for very late anthracycline-induced dilated cardiomyopathy and the need for prolonged cardiovascular surveillance in cancer survivors, while confirming the efficacy of standard HFrEF medical therapy.
May support extended surveillance in anthracycline survivors; leaves open optimal duration and protocols for late cardiotoxicity.
Background: Anthracyclines are key agents in the treatment of various malignancies, including breast cancer. Their clinical utility is limited by cardiotoxicity, which may present acutely or many years after treatment. Late-onset cardiotoxicity can manifest as dilated cardiomyopathy and heart failure, often with insidious progression. Case presentation: We describe a 60-year-old woman with progressive dyspnea and signs of heart failure, ten years after completing anthracycline-based chemotherapy for breast cancer. Echocardiography revealed left ventricular dysfunction with dilation and functional mitral regurgitation. Cardiac magnetic resonance imaging confirmed dilated cardiomyopathy. After exclusion of ischemic, infectious, metabolic, and other etiologies, a diagnosis of anthracycline-induced cardiomyopathy was made. The patient responded favorably to guideline-directed medical therapy. Conclusion: This case highlights the potential for very late cardiotoxicity following anthracycline exposure and emphasizes the need for long-term cardiac surveillance in cancer survivors. Recognition of risk factors and early diagnosis are essential to improve outcomes.
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Bennoui et al. (2026) conducted a case report in Late-onset anthracycline-induced dilated cardiomyopathy (n=1). Anthracycline-based chemotherapy was evaluated on Development of dilated cardiomyopathy and heart failure. Anthracycline exposure can cause very late-onset dilated cardiomyopathy and heart failure, as demonstrated by severe left ventricular dysfunction emerging a full decade after breast cancer treatment.
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