ArticleArquivos brasileiros de cardiologia2015
Cardiac sympathetic hyperactivity after chemotherapy: early sign of cardiotoxicity?
Article in Arquivos brasileiros de cardiologia, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 25 citations in OpenAlex.
- MIBG cardiac imaging compared to ejection fraction in evaluation of cardiotoxicity: a systematic review.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2022Pooled it
- Update of the Brazilian Guideline on Nuclear Cardiology - 2020.Arquivos brasileiros de cardiologia · 2020Guideline
- Cardiovascular Autonomic Dysfunction in Cancer Therapy: Clinical Manifestations and Management.Cardiology research · 2026Review
- Sympathetic Neural Overactivation, Vascular Dysfunction, and Exercise Intolerance in Long-Term Survivors of Breast Cancer Treated With Doxorubicin and Trastuzumab-Based Chemotherapy.Journal of the American Heart Association · 2026Article
- The neuronal imaging in cardiology: 123I-Biophysical reviews · 2025Review
- Acetylcholinesterase inhibition protects against trastuzumab-induced cardiotoxicity through reducing multiple programmed cell death pathways.Molecular medicine (Cambridge, Mass.) · 2023Article
- Doxorubicin Dose-Dependent Impact on Physiological Balance-A Holistic Approach in a Rat Model.Biology · 2023Article
- Assessment of short-term effects of thoracic radiotherapy on the cardiovascular parasympathetic and sympathetic nervous systems.Frontiers in neuroscience · 2023Article
- Choline Protects the Heart from Doxorubicin-Induced Cardiotoxicity through Vagal Activation and Nrf2/HO-1 Pathway.Oxidative medicine and cellular longevity · 2022Article
- Brazilian Position Statement on the Use Of Multimodality Imaging in Cardio-Oncology - 2021.Arquivos brasileiros de cardiologia · 2021Article
- Impact of respiratory physical therapy on heart rate autonomic control in children with leukemia.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2021Article
- Clinical and Research Tools for the Study of Cardiovascular Effects of Cancer Therapy.Journal of cardiovascular translational research · 2020Review
- Precision Cardio-Oncology.Journal of nuclear medicine : official publication, Society of Nuclear Medicine · 2019Review
- Breakthroughs in modern cancer therapy and elusive cardiotoxicity: Critical research-practice gaps, challenges, and insights.Medicinal research reviews · 2018Review
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundChemotherapy with anthracyclines and trastuzumab can cause cardiotoxicity. Alteration of cardiac adrenergic function assessed by metaiodobenzylguanidine labeled with iodine-123 (123I-mIBG) seems to precede the drop in left ventricular ejection fraction.
objectiveTo evaluate and to compare the presence of cardiovascular abnormalities among patients with breast cancer undergoing chemotherapy with anthracyclines and trastuzumab, and only with anthracycline.
methodsPatients with breast cancer were analyzed clinical, laboratory, electrocardiographic and echocardiographic and cardiac sympathetic activity. In scintigraphic images, the ratio of 123I-mIBG uptake between the heart and mediastinum, and the washout rate were calculated. The variables were compared between patients who received anthracyclines and trastuzumab (Group 1) and only anthracyclines (Group 2).
resultsTwenty patients, with mean age 57 ± 14 years, were studied. The mean left ventricular ejection fraction by echocardiography was 67.8 ± 4.0%. Mean washout rate was 28.39 ± 9.23% and the ratio of 123I-mIBG uptake between the heart and mediastinum was 2.07 ± 0.28. Of the patients, 82% showed an increased in washout rate, and the ratio of 123I-mIBG uptake between the heart and mediastinum decreased in 25%. Concerning the groups, the mean washout rate of Group 1 was 32.68 ± 9.30% and of Group 2 was 24.56 ± 7.72% (p = 0,06). The ratio of 123I-mIBG uptake between the heart and mediastinum was normal in all patients in Group 2, however, the Group 1, showed 50% the ratio of 123I-mIBG uptake between the heart and mediastinum ≤ 1.8 (p = 0.02).
conclusionIn women with breast cancer undergoing chemotherapy, assessment of cardiac sympathetic activity with 123I-mIBG appears to be an early marker of cardiotoxicity. The combination of chemotherapy showed higher risk of cardiac adrenergic hyperactivity.
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