CMR shows that anthracycline cardiotoxicity is common in women treated for early breast cancer and associated with undiagnosed hypertension; but cannot be reliably detected using late-gadolinium enhancement imaging

Background A growing number of patients with cancer are at risk from chronic anthracycline cardiotoxicity (cAC) as a result of improving cancer prognosis. Although susceptibility is cumulative dose-related, it is also idiosyncratic. Furthermore, at present there is no way to reliably identify those at risk. The common practice of serially measuring LV ejection fraction (LVEF) only identifies cardiotoxicity after significant damage has been incurred. We hypothesised that risk of cAC could be determined from patient and treatment factors, known at baseline, together with assessment of the cardiac response to the 1st dose of anthracycline. Here we report the prevalence of cAC detected using CMR, together with the associations with baseline BP and anthracycline dose.