Authors
Cynthia Margaretha, Naomi Dalimunthe, Heny Syahrini Lubis, Taufik Sungkar, Melati Silvanni Nasution
Published in
Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina. Volume 23. Issue 2. Jun 18, 2026. Epub Jun 18, 2026.
Abstract
To evaluate early within-patient changes in left ventricular ejection fraction (LVEF) and to describe these early LVEF trajectories according to CTox risk category.
This retrospective observational cohort study included 100 breast cancer patients treated at Adam Malik Hospital, from January to December 2024. CTox score was calculated prior to therapy initiation. Echocardiography was performed before the third cycle and after the fourth cycle of anthracycline- or trastuzumab-based therapy. The primary endpoint was early within-patient change in LVEF.
Based on CTox classification, 53% of patients were categorized as low-to-moderate risk and 47% as high-to-very high risk. Mean LVEF decreased from 62.64 ± 7.80% to 59.95 ± 7.46%, with a mean change of -2.69 ± 9.01% (p = 0.004). Early LVEF change did not differ between risk groups (between-group difference 0.54%; 95% CI, -2.97 to 4.05; p = 0.766). CTox score was not associated with early LVEF change when modelled as a continuous variable (β = 0.55; p = 0.453) or after adjustment for treatment regimen (β = 0.92; p = 0.212). Treatment type was independently associated with early LVEF change (p = 0.026).
A modest early decline in LVEF was observed during initial therapy cycles. Early LVEF trajectory was not associated with CTox risk category but was influenced by treatment regimen. These findings should be interpreted as early imaging trajectory data rather than cardiotoxicity risk prediction.
PMID:
42592971
Bibliographic data and abstract were imported from PubMed on 13 Aug 2026.
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