Chemotherapy may cause heart damage in diabetic patients

Cancer patients who also suffer from diabetes also risk heart damage because of chemotherapy, a study has found. The study found that cardiotoxicity induced by chemotherapy with anthracyclines is being increasingly reported, mainly because a smaller proportion of patients now die from cancer.

"In the coming years this cardiotoxicity looks set to increase the burden of heart failure in cancer survivors," said Ana Catarina Gomes, cardiologist in training at the Hospital Garcia de Orta in Almada, Portugal. "The good news is that cardiotoxicity can be reversible in the early stages before overt heart failure develops. Surveillance programmes are hugely beneficial, particularly in the first year of treatment when up to 80 per cent of the systolic dysfunction develops," Gomes added.

The research investigated factors that could affect the likelihood of patients having heart damage after treatment with anthracyclines. Of 83 patients included in the surveillance programme, 54 had breast cancer, 20 had lymphoma and nine had gastric cancer.

"Patients with diabetes had a significantly greater decrease in global longitudinal strain during treatment, despite having baseline levels similar to non-diabetics," the research noted. According to Gomes, sub-clinical reduction in global longitudinal strain is an early predictor of heart failure and was particularly pronounced in patients with diabetes.

"It is possible that the trend for greater reduction in patients with hypertension might become statistically significant in a larger study," Gomes added. The researchers hypothesised that cancers themselves could have direct cardiotoxic effects induced by cytokines.

The cardiotoxic effects may vary with the type of cancer, study noted. Researchers suggested that cancer patients should strictly control cardiovascular risk factors with lifestyle changes and, if necessary, with medication. The findings were presented at EuroEcho-Imaging 2016 in Leipzig, Germany.