BACKGROUND:Hypertension is a risk factor for experiencing left ventricular ejection fraction (LVEF) declines during receipt of potentially cardiotoxic breast cancer (BC) treatment. We sought to determine whether the hypertension stage is associated with LVEF decline during BC treatment.METHODS:Across 24 centers, cardiac magnetic resonance measures of LVEF and brachial arterial blood pressure (BP) measurements were performed in women with stages I to III BC before and 3 months after initiating potentially cardiotoxic chemotherapy. Using multivariable analysis, we assessed in a blinded fashion the association between 3-month ΔLVEF and precancer treatment American Heart Association/American College of Cardiology stages of hypertension.RESULTS:Among 204 women, age averaged 56±1 years with 75% being White and 20% of Black race. Participants received anthracycline (45.6%), trastuzumab (22.5%), cyclophosphamide (52.9%), or paclitaxel (50%). After accounting for pretreatment LVEF, diabetes status, tobacco use, age, the number of antihypertensive medications, and body mass index, those with stage II hypertension experienced an LVEF decline of −2.89% ([95% CI, −0.69% to −5.19%]; P=0.01) relative to individuals with normal BP. Other stages saw nonsignificant declines relative to normal BP to elevated BP (−1.63% [95% CI, −0.62% to 3.88%]; P=0.16) and stage I hypertension (−0.94% [95% CI, −0.90% to 2.78%]; P=0.32).CONCLUSIONS:Compared with women receiving treatment for BC with normal BP, there is a stronger association of decline in LVEF in women with stage II hypertension relative to women with other hypertension stages. This raises the possibility that stage along with hypertension presence may be associated with an increased risk for the LVEF decline among women receiving potentially cardiotoxic chemotherapy for BC.REGISTRATION:URL: https://www.clinicaltrials.gov; Unique identifier: NCT02791581 and NCT01719562.

中文翻译：

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接受乳腺癌辅助化疗的女性高血压严重程度和左心室射血分数下降 (WF-97415 UPBEAT)

背景：高血压是接受潜在心脏毒性乳腺癌（BC）治疗期间左心室射血分数（LVEF）下降的危险因素。我们试图确定高血压分期是否与 BC 治疗期间 LVEF 下降相关。方法：在 24 个中心，对 I 至 III BC 期女性进行心脏磁共振测量 LVEF 和肱动脉血压 (BP) 测量。开始潜在心脏毒性化疗后 3 个月。使用多变量分析，我们以盲法评估了 3 个月 ΔLVEF 与癌前治疗之间的关联 美国心脏协会/美国心脏病学会高血压分期。 结果：在 204 名女性中，平均年龄为 56±1 岁，其中 75% 为白人和白人20%的黑人种族。参与者接受蒽环类药物（45.6%）、曲妥珠单抗（22.5%）、环磷酰胺（52.9%）或紫杉醇（50%）治疗。考虑到治疗前的 LVEF、糖尿病状况、烟草使用、年龄、抗高血压药物的数量和体重指数后，II 期高血压患者的 LVEF 下降了 -2.89%（[95% CI，-0.69% 至 -5.19） %]; P =0.01) 相对于血压正常的个体。其他阶段的血压相对于正常血压到升高血压（−1.63% [95% CI, −0.62% to 3.88%]; P =0.16）和 I 期高血压（−0.94% [95% CI, -0.90% to 2.78%]；P = 0.32）。结论：与接受 BC 治疗但血压正常的女性相比，II 期高血压女性的 LVEF 下降与其他高血压期女性的相关性更强。这提出了这样一种可能性：在接受潜在心脏毒性化疗的 BC 女性中，分期与高血压的存在可能与 LVEF 下降的风险增加有关。唯一标识符：NCT02791581 和 NCT01719562。