Effect of changes in body mass index on left heart function in early breast cancer patients undergoing anthracycline chemotherapy / 肿瘤研究与临床

ABSTRACT

Objective:To explore the effect of changes in BMI (&Delta;BMI) on left ventricular function in early breast cancer patients undergoing anthracycline chemotherapy.Methods:The clinical data of 170 breast cancer patients treated in the Lianyungang Oriental Hospital from January 2018 to October 2021 were retrospectively analyzed. The clinicopathological data and cardiac color doppler ultrasound examination results of the patients were collected. Single-factor and multiple-factor were used to analyze the risk factors of cardiotoxicity in patients after chemotherapy. &Delta;BMI was calculated and the receiver operating characteristic (ROC) curve was drawn; the cut-off value of the &Delta;BMI was measured to obtain the diagnostic accuracy.Results:Compared with before chemotherapy, the mean values of BMI, left ventricular end-diastolic volume (EDV), left ventricular end-systolic volume (ESV), left ventricular end-diastolic diameter (LVD), and left ventricular end-systolic diameter (LVS) were increased after chemotherapy, while left ventricular ejection fraction (LVEF) value was decreased. Before and after chemotherapy, the differences between BMI [(22.30±1.88) kg/m 2 vs. (23.59±2.32) kg/m 2] and LVEF [(63.69±4.69)% vs. (59.08±4.28)%] were statistically significant ( t = 3.40 and 4.98, all P < 0.05). The range of &Delta;BMI was 0-41.3%, and the range of the change of LVEF (&Delta;LVEF) was 0-15.9%. There was a significant correlation between &Delta;LVEF and &Delta;BMI ( r = 0.709, P < 0.001). The incidence of cardiotoxicity was 21.2% (36/170). Logistic regression analysis showed that BMI( OR = 1.639, 95% CI 1.263-2.127, P = 0.000) and &Delta;BMI ( OR = 1.147, 95% CI 1.071-1.228, P = 0.000) were independent risk factors for cardiotoxicity in early breast cancer patients undergoing anthracycline chemotherapy. According to the cardiotoxicity, the area under the ROC curve of &Delta;BMI and BMI was 0.757 and 0.687, respectively. When the &Delta;BMI value was 4.28%, the maximum Youden index was 0.399, the sensitivity was 0.750, and the specificity was 0.649. Conclusion:For breast cancer patients treated with anthracycline chemotherapy, &Delta;BMI can be used as an effective indicator for predicting cardiotoxicity; when &Delta;BMI exceeds 4.28%, the risk of cardiotoxicity is high.