Background: Early detection and treatment of cardiotoxicity are essential for reducing cardiac events. However, a reliable predictive model for cardiotoxicity in patients with breast cancer receiving chemotherapy is lacking.
Objectives: In this study, we aimed to develop a risk prediction model and establish effective surveillance for cardiotoxicity in patients with breast cancer undergoing chemotherapy.
Methods: Patients with breast cancer scheduled for neoadjuvant and/or adjuvant chemotherapy were prospectively screened at 25 participating institutions between August 2017 and March 2020. Cardiotoxicity was defined as a reduction in left ventricular ejection fraction of >10% point from baseline to a value <53%.
Results: The study included 559 chemotherapy-naïve female patients. Cardiotoxicity was observed in 46 of 559 patients (8.2%) during a median follow-up period of 366 days (Q1-Q3: 365–367 days). The CHECK HEART score consisted of six variables: heart rate, left ventricular global longitudinal strain, left ventricular end-systolic and end-diastolic diameters, right ventricular fractional area change, and treatment with anthracycline and trastuzumab. The time-dependent area under the receiver operating characteristic curve (AUC) at 12 months based on pre-treatment data demonstrated acceptable accuracy (AUC 0.82, 95% confidence interval [CI] 0.76-0.89).
Conclusions: The developed multivariable risk prediction models can accurately predict cardiotoxicity and support effective surveillance in patients with breast cancer receiving chemotherapy.
JACC: Asia Editor-in-Chief
Jian’an Wang, MD, PhD, FACC
CME Editor
Kenneth A. Ellenbogen, MD
Author
Talal Alnabelsi, MD, FACC
Important Dates
Date of Release: February 3, 2026
Term of Approval/Date of CME/MOC Expiration: February 2, 2027