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Objectives: Many patients with breast cancer (BC) require cardiotoxic anthracycline-based chemotherapy. We intended to assess the early cardiotoxic effects of doxorubicin utilizing cardiac magnetic resonance (CMR) imaging. Material and Methods: Forty-nine patients including 21 otherwise healthy females with BC at a mean age (±SD) of 47.62 ± 9.07 years and 28 normal controls at a mean age (±SD) of 45.18 ± 4.29 years were recruited. They underwent CMR and transthoracic echocardiography at baseline and 7 days after four biweekly cycles of doxorubicin and cyclophosphamide. Biventricular functional, volumetric, global strain, and tissue characterization findings were analyzed and compared with those of 28 controls. Results: In post-chemotherapy CMR, 4 patients (19.04%), three symptomatic and one asymptomatic, exhibited evidence of doxorubicin cardiotoxicity. Significant differences in biventricular ejection fraction, left ventricular end-systolic volume index, and all 3D global strain values were noted after chemotherapy in comparison with the baseline (all P < 0.05). More than half of the study population showed a significant change in all right ventricular global strain values. One patient (4.76%) exhibited evidence of diffuse myocardial edema in post-chemotherapy CMR, and 3 patients (14.28%) showed myocardial fibrosis. The study participants were clinically followed up for 4–10 months (mean = 7 months). Overall, 8 patients (38.09%) complained of dyspnea on exertion and fatigue on follow-up. None of the CMR markers was associated with the development of symptoms. Conclusion: Our investigation revealed striking changes in CMR parameters in the follow-up of BC patients treated with cardiotoxic chemotherapy. These exclusive CMR features assist in the early initiation of preventive cardiac strategies.

Funding Acknowledgements Type of funding sources: Public hospital(s). Main funding source(s): 1. Tehran University of Medical Sciences 2. Iran University of Medical Sciences Assessment of early cardiotoxic adverse effects of Doxorubicin-containing regimens in breast cancer patients. Abstract: Introduction BC is the most prevalent cancer among women and comprises about 30% of cancers in this population group1. Numerous patients with breast cancer (BC) require cardiotoxic anthracycline-based chemotherapy. Purpose We intended to assess the early cardiotoxic effects of doxorubicin utilizing cardiac magnetic resonance (CMR) imaging. Methods Frothy-nine patients including 21 otherwise healthy females with BC at a mean age (±SD) of 47.62 ± 9.07 years and 28 normal controls at a mean age (±SD) of 45.18 ± 4.29 years were recruited. BC cases underwent both CMR and TTE at baseline and seven days after four biweekly cycles of Doxorubicin and Cyclophosphamide. Functional, volumetric, and strain parameters, including global longitudinal (GLS), circumferential (GCS), and radial strain (GRS), were analyzed.  The findings compared with those of 28 controls.  Results In post-chemotherapy CMR, four patients (19.04%) displayed evidence of drug cardiotoxicity. Ventricular ejection fraction, left ventricular end-systolic volume index, and strain values significantly changed after chemotherapy (all Ps &lt; 0.05). One patient (4.76%) had myocardial edema in post-chemotherapy CMR, and three patients (14.28%) had evidence of myocardial fibrosis. In the follow-up time of 4 to 10 months (mean: seven months) after chemotherapy, eight patients (38.09%) complained of dyspnea on exertion and fatigue. None of the CMR parameters had any correlation with the evolution of symptoms.  Conclusion We demonstrated a significant difference in ventricular ejection fraction and global strain values early after Doxorubicin chemotherapy. Exclusive CMR parameters can aid in the early initiation of preventive cardiac strategies.