Key result
Low-dose bisoprolol fails to preserve 6-month LVEF vs placebo during anthracycline chemotherapy.
Why the study?
Anthracyclines cause dose-dependent cardiotoxicity in breast cancer chemotherapy, and while beta-blockers have shown cardioprotective effects, evidence regarding bisoprolol evaluated with comprehensive echocardiography remains limited.
Does prophylactic low-dose bisoprolol preserve left ventricular ejection fraction and prevent subclinical cardiac dysfunction in adult female patients with breast cancer undergoing anthracycline-based chemotherapy?
RCT (n=50)
Triple-blind
1:1 computer-generated block randomization (fixed block size of 4)
No
Does prophylactic low-dose bisoprolol preserve left ventricular ejection fraction and prevent subclinical cardiac dysfunction in adult female patients with breast cancer undergoing anthracycline-based chemotherapy?
In women with breast cancer receiving anthracyclines, prophylactic low-dose bisoprolol (2.5 mg/day) prevented subclinical left and right ventricular remodeling and preserved global longitudinal strain and TAPSE at 6 months despite unchanged LVEF in both groups.
Answers are grounded in this paper and cite their sources.
Supports low-dose bisoprolol during anthracycline chemotherapy in breast cancer; extends beta-blocker cardioprotection to structural and strain endpoints.
Background: Anthracyclines are cornerstone agents in breast cancer chemotherapy. However, they can cause dose-dependent cardiotoxicity, potentially impairing long-term cardiac function. Beta-blockers have demonstrated cardioprotective effects. However, evidence regarding bisoprolol, particularly using comprehensive echocardiographic evaluations, remains limited. This study aimed to evaluate the cardioprotective effects of low-dose bisoprolol against anthracycline-induced subclinical cardiac dysfunction in patients with breast cancer. Methods: tests, and categorical variables were analyzed using the Chi square test. Statistical significance was defined as P<0.05. Results: A total of 50 patients completed the trial (25 in the bisoprolol group and 25 in the placebo group). LVEF remained stable in both groups. Compared with the placebo group, bisoprolol demonstrated significantly more favorable structural and functional changes, including a reduction in LVEDD (mean change=-0.172 cm; 95% CI=-0.343 to -0.001; P=0.049), LVESD (mean change=-0.156 cm; 95% CI=-0.295 to -0.172; P=0.029), and LVEDV (mean change=-7.920 mL; 95% CI=-15.174 to -0.666; P=0.033); improved GLS (mean change=0.974; 95% CI=0.083 to 1.865; P=0.033); and better preserved TAPSE (mean change=0.168 cm; 95% CI=0.101 to 0.234; P<0.001). Conclusion: IRCT20130701013828N8.
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Mirdamadi et al. (2026) conducted an RCT in Locally advanced breast cancer (Stage II or III) scheduled for anthracycline-based chemotherapy (n=50). Bisoprolol vs. Placebo was evaluated on Left ventricular ejection fraction (LVEF) at 6 months following six cycles of chemotherapy (p=0.731). Low-dose bisoprolol showed no difference in 6-month LVEF vs placebo during anthracycline chemotherapy, though it improved GLS and LVEDV.
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