Time course of hypertension and myocardial dysfunction following anthracycline chemotherapy in pediatric patients

Anthracyclines are associated with cardiac dysfunction. Little is known about the interplay of pre-existing hypertension and treatment response. We aimed to investigate the relationship between hypertension and the development of cancer therapy-related cardiac dysfunction (CTRCD) in pediatric patients treated with anthracycline chemotherapy. Pediatric patients with cancer who received anthracycline chemotherapy from 2013 to 2021 were retrospectively included. Serial cardiac assessments were conducted during and after chemotherapy. The primary outcome was the development of CTRCD, classified as mild, moderate, or severe according to contemporary definitions. Among 190 patients undergoing anthracycline chemotherapy, 34 patients (17.9 %) had hypertension (24 patients Stage 1, and 10 patients Stage 2) at baseline evaluation. Patients underwent chemotherapy for a median of 234.4 days (interquartile range 127.8–690.3 days) and were subsequently followed up. Hypertension was frequent during follow-up 31.3 % (0–3 months), 15.8 % (3–6 months), 21.9 % (0.5–1 years), 24.7 % (1–2 years), 31.1 % (2–4 years) and 35.8 % (beyond 4 years) (P for trend